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目的探讨器官获取手术前中国Ⅲ型心死亡供体器官功能的维护措施。方法对57例中国Ⅲ型心死亡供体器官获取前的维护方法进行回顾性分析,重点总结对肝、肾功能的保护、维持生命体征稳定的措施和体外膜肺氧合系统(ECMO)的使用。结果 57例均捐献成功,共捐出肾脏、肝脏142个。其中我院实施肝移植12例,手术全部成功,2例术后发生胆道狭窄,1例肝癌术后8个月肿瘤复发,1例发生胆瘘。肾移植107例,发生急性移植肾小管坏死30例,经血液或腹膜透析治疗后29例移植肾功能逐渐恢复,1例死亡;急性排斥反应24例,经治疗后均逆转。结论器官捐献供体功能的维护对移植后移植物功能的恢复十分重要,需尽早介入护理干预,使器官损害程度降至最低,提高其利用率及移植效果。
Objective To investigate the maintenance of organ function in donor organs of type Ⅲ heart death before surgery in China. Methods Retrospective analysis was made on the methods of maintenance before the acquisition of donor organs of type Ⅲ heart death in China. The methods of protecting the liver and renal functions, maintaining the stability of vital signs, and the use of extracorporeal membrane oxygenation system (ECMO) were summarized . Results 57 cases were donated successfully, a total of donated kidney, liver 142. Among them, 12 cases of liver transplantation were performed in our hospital. All the procedures were successful. Two cases had biliary stricture after operation. One case had recurrence of tumor at 8 months and one case had biliary fistula. Of the 107 renal transplant recipients, 30 developed acute renal tubular necrosis. After transplanting blood or peritoneal dialysis, the graft function of 29 patients gradually recovered and 1 died. The acute rejection reaction was reversed after treatment. Conclusion The maintenance of organ donation donor function is very important for the recovery of graft function after transplantation. Nursing intervention should be involved as soon as possible to minimize the degree of organ damage and improve its utilization rate and transplantation effect.