高度致敏受者脱敏治疗及肾移植术的护理

目的:探讨高度致敏受者行脱敏治疗及肾移植术的观察和护理。方法:回顾性分析35例高敏受者采用血浆置换和免疫球蛋白脱敏治疗后行肾移植术的临床及护理资料,总结观察和护理要点。结果:本组患者术后未发生超急性排斥反应。发生急性排斥反应10例,其中6例为早期严重的急性体液性排斥反应,4例为急性细胞性排斥反应。1例并发移植肾破裂,经抢救后行移植肾修补术。1例并发急性肾小管坏死,经血液透析7周后移植肾功能恢复。结论:做好术前脱敏治疗、术后监护及并发症的护理工作,能够促进脱敏治疗后肾移植成功和患者尽快康复。术后的护理重点是监测排斥反应和预防感染。

Nursing for highly sensitized recipients with kidney transplantation after desensitization therapy

Objective：To evaluate the clinical observation and nursing of highly sensitized recipients（HSP） with kidney transplantation after desensitization therapy.Methods：The clinical and nursing data of 35 HSPs received kidney transplantation after desensitization therapy with plasmapheresis plus intravenous immunoglobulin were retrospectively analyzed.The monitoring and nursing experience were summarized.Results：No hyperacute acute occurred.There were 10 cases of acute rejection,including 6 cases of early severe acute humoral rejection,one case suffered from graft rupture and treated by surgical repair,another suffered from acute tubunar necrosis and treated by 7 weeks of hemodialysis,all grafts recovered well.Through tight surveillance and careful nursing,severe infection complications were avoided.Conclusions：The desensitization therapy before transplantation,tight surveillance and careful nursing for complications were helpful to successful kidney transplantation of HSP.The key points of nursing for these recipients are early finding signs and symptoms of rejection and prevention from infective complications.