肾移植术后急性肾小管坏死12例护理体会

目的:探讨肾移植术后急性肾小管坏死(ATN)的发病因素和预防护理措施。方法:对284例肾移植患者术后采取合理调控血压、预防心功能衰竭,早期发现并及时采取休克、营养支持、预防感染等措施,以减少ATN的发生。结果:本组术后并发ATN12例,因肺内感染多器官功能衰竭死亡1例,心梗死亡1例,其余患者均治愈出院。结论:心衰、低血压、缺血时间过长、灌注不良或灌注过多是致ATN发生的关键因素,术后精心护理是提高移植肾存活率的保证。

Nursing care of 12 cases under kidney transplantation who complicated acute tubular necrosis

Objective: To explore pathogenic factors and preventive nursing care of patients under kidney transplantation who complicated acute tubular necrosis. Methods: Rational regulation of the blood pressure was made for 284 cases after operation, prevention of heart function failure was enhanced, anticipation and the treatment of shock was taken in order to reduced the occurrence of ATN. Results: In 12 cases of complications died because of multiple organ failure,1 died because of myocardial infarction and the rest were all cured. Conclusion: Heart failure, hypotension, long ischemic time, hypoperfusion or hyperperfusion are the keys to cause ATN, meticulous nursing care after operation can enhance survival rate of kidney transplant.