肾移植围手术期的补液监控

目的探讨肾移植围手术期的水电解质平衡维护及营养支持的方法和时机。方法以移植肾动、静脉血流开放时间为分界点,总结患者围手术期的生理特点,分析患者血流开放前、多尿期及恢复期的营养支持治疗及水、电解质平衡的维护,并依据输液方案进行治疗。结果移植肾动、静脉血流开放前的输液应以胶体如浓缩红细胞、血浆及清蛋白为主,多尿期应规律及时补充水及电解质,适当的营养支持有助于吻合口愈合,尿量稳定后应预防代谢性酸中毒。结论肾移植患者围手术期内环境复杂多变,及时有效地维护水、糖、电解质平衡及营养支持治疗至关重要。

Fluid replacement therapy during renal transplantation recipients' peri-operative period

Objective] To explore the method and opportunity of the nutritional support and the handling of the water and electrolyte balance in the renal transplantation recipients during their peri-operative period. Method] The peri-operative physiological features of the renal transplantation recipient were summarized retrospectively. The recipients' condition during the peri-operative period was divided into two stages at the point of opening of the allograft blood current. Each stage of the nutritional support and the handling of the water and electrolyte balance were analyzed respectively. Results] The colloid such as erythrocyte and blood plasma and albumin should be mainly infused before the opening of the allograft blood current. And the liquid and electrolyte should be administrated promptly and in regular pattern during the diuresis stage. The healing of the stoma can be benefited from the adequate nutritional support. The metabolic acidosis still should be prevented when the urinary production returns normal.Conclusions] The internal environment of the renal transplantation recipient during their peri-operative period is complicated. The peri-operation therapy of the transplantation is important for the recovery of the patient.