CAJ | 학술논문

目的探讨肾移植患儿围手术期液体管理的方法和效果。方法对48例行肾移植术的患儿，术前做好心功能和治疗依从性评估，根据儿童的循环特点，制订围手术期的输液方案，保持电解质平衡，减少因输液导致的各种并发症。结果本组48例患儿中有29例术后第1 d发生不同程度的电解质紊乱，经处理后在术后第2 d得到改善。出现少尿5例，移植肾功能延迟恢复3例，贫血9例，经控制输液量，改善肾脏微循环后，患儿移植肾功能恢复正常。结论制订合理的输液计划，保持电解质平衡，做好多尿、少尿和无尿期及移植肾功能延迟恢复患儿的液体管理对降低围手术期并发症发生，保证患儿顺利渡过围手术期具有重要的意义。
목적탐토신이식환인위수술기액체관리적방법화효과。방법대48례행신이식술적환인，술전주호심공능화치료의종성평고，근거인동적순배특점，제정위수술기적수액방안，보지전해질평형，감소인수액도치적각충병발증。결과본조48례환인중유29례술후제1 d발생불동정도적전해질문란，경처리후재술후제2 d득도개선。출현소뇨5례，이식신공능연지회복3례，빈혈9례，경공제수액량，개선신장미순배후，환인이식신공능회복정상。결론제정합리적수액계화，보지전해질평형，주호다뇨、소뇨화무뇨기급이식신공능연지회복환인적액체관리대강저위수술기병발증발생，보증환인순리도과위수술기구유중요적의의。
Objective To explore the strategies and effectiveness of perioperative fluid administration during pediatric kidney transplantation.Methods In our study,we evaluated the heart function and compliance of pediatric patients preoperatively,and then formulated perioperative fluid management strategy according to children’s circulation feature.The electrolytic balance was kept and complications were prevented.Results Twenty-nine out of all 48 children experienced electrolyte disturbance to different extents on day 1 postoperatively,which improved on day 2 after prompt management.There were five cases of oliguria,three cases of delayed graft function(DGF),one case of heart failure and multiple organ failure respectively.Conclusion Such nursing strategies like formulation of reasonable fluid infusion plan according to the physiological features of pediatric recipients,keeping the electrolytic balance and careful management of fluid at polyuria,oliguria and anuria,care critical for the children to live through the perioperative periods.