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安徽省首例成人活体肝移植的医护一体化管理

张玲 胡静荣 余孝俊 赵红川 耿小平

张玲, 胡静荣, 余孝俊, 赵红川, 耿小平. 安徽省首例成人活体肝移植的医护一体化管理[J]. 中华全科医学, 2024, 22(3): 389-392. doi: 10.16766/j.cnki.issn.1674-4152.003409
引用本文: 张玲, 胡静荣, 余孝俊, 赵红川, 耿小平. 安徽省首例成人活体肝移植的医护一体化管理[J]. 中华全科医学, 2024, 22(3): 389-392. doi: 10.16766/j.cnki.issn.1674-4152.003409
ZHANG Ling, HU Jingrong, YU Xiaojun, ZHAO Hongchuan, GENG Xiaoping. Doctor-nurse integrated management in the first case of adult living donor liver transplantation in Anhui Province[J]. Chinese Journal of General Practice, 2024, 22(3): 389-392. doi: 10.16766/j.cnki.issn.1674-4152.003409
Citation: ZHANG Ling, HU Jingrong, YU Xiaojun, ZHAO Hongchuan, GENG Xiaoping. Doctor-nurse integrated management in the first case of adult living donor liver transplantation in Anhui Province[J]. Chinese Journal of General Practice, 2024, 22(3): 389-392. doi: 10.16766/j.cnki.issn.1674-4152.003409

安徽省首例成人活体肝移植的医护一体化管理

doi: 10.16766/j.cnki.issn.1674-4152.003409
基金项目: 

国家自然科学基金青年基金项目 81702829

详细信息
    通讯作者:

    张玲,E-mail:thtszl1996@sina.com

  • 中图分类号: R735.7  R73-35

Doctor-nurse integrated management in the first case of adult living donor liver transplantation in Anhui Province

  • 摘要:   目的  总结安徽省首例成人成功活体肝移植的康复管理经验。  方法  2021年12月安徽医科大学第一附属医院器官移植肝胆胰外科成立医护移植专科小组,对肝移植供体、受体移植评估期、围手术期、居家管理期3个阶段实施医护一体化精准管理。移植评估期从解剖学、生理学和社会心理学3个方面进行医护一体化的综合评估与干预,尤其在活体肝移植中需获得二级伦理委员会审批同意手术,做好肝移植供体和受体两方面的整体评估方可进行手术,为手术成功奠定基础;围手术期除外科围手术期常规措施外,从术前准备、免疫抑制药物精细化管理、移植器官功能监测、保护性隔离与感染防控、优化快速康复管理策略5个方面进行全面细致化的治疗与护理,是供体、受体顺利康复的关键;居家管理期医护协作通过各种干预提升受者的自我管理效能水平,促使患者采取健康行为,运用血药浓度监测法、药片计数法以及问卷调查法追踪肝移植受体居家期间服药依从性,并优化术后复查流程。  结果  肝移植供体、受体手术顺利,肝移植供体于术后第11天康复出院,肝移植受体于术后第18天康复出院,肝移植供体、受体血生化指标提示肝功能良好,免疫抑制剂血药浓度维持在理想水平,肝移植供体残肝和肝移植受体供肝均增生满意。居家管理期间密切随访,术后8个月供体、受体均恢复良好。  结论  成人活体肝移植手术需要医护团队密切合作,以严谨的态度、高质量的管理,实施精准的诊疗护理措施,从而获得供体、受体双方的满意恢复。

     

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  • 收稿日期:  2023-06-11
  • 网络出版日期:  2024-05-27

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