1例活体小肠移植术后并发血管吻合口血栓患儿的护理

总结1例活体小肠移植术后并发血管吻合口血栓患儿的护理措施。护理要点：尽早识别血管吻合口血栓,快速启动急救措施;采取负压封闭引流治疗,及时处理切口感染;实施个体化营养支持方案,改善营养状况;加强观察,动态监测免疫抑制剂血药浓度,警惕发生排异反应;关注患儿心理健康,提供心理支持;制订随访计划,做好延续性护理。经过29 d的积极治疗和精心护理,患儿病情好转,顺利转入普通病房,术后67 d康复出院。出院后2个月随访时,患儿肠功能恢复良好,能自行经口进食。

Clinical analysis of a child with vascular anastomotic thrombosis after living donor small bowel transplantation

To summarize the nursing care of a child with vascular anastomotic thrombosis after living small bowel transplantation. Essentials for nursing care：early identification of vascular anastomotic thrombosis and emergency care;negative pressure occlusion drainage therapy to timely treatment of incision infection;implementing individualized nutrition support programmes to improve nutritional status;dynamic monitoring of immunosuppressant plasma concentration,and being vigilant for rejection reaction;paying attention to the mental health of children and providing psychological support;developing a follow-up plan for continuity of care. After 29 days of careful treatment and nursing care,the child’s condition improved and was successfully transferred to the general ward,and discharged 67 days after surgery. At 2 months of follow-up after discharge,the intestinal function of the child recovered well,and the child can eat by himself presently.