ABSTRACT
Objective To investigate the nursing points of pancreatic leakage after upper abdominal multiple organ transplantation. Methods A retrospective study was conducted on the nursing experience of two patients with end-stage liver disease and type 2 diabetes mellitus who were complicated with pancreatic leakage after upper abdominal multiple organ transplantation from March 2009 to July 2015. Results The blood glucose of these patients returned to normal level within 1 week after operation and insulin was discontinued. Pancreatic leakage was occurred in the two patients at 14 and 21 days after operation, respectively. They were both successfully discharged after active treatments and nursing cares including completely drainage, the application of drugs that inhibited the secretion of pancreatic enzymes and digestive tract glands, strengthening infection control, nutritional support and other conservative treatments. Conclusions It is the key to improve the recovery of pancreatic leakage after upper abdominal multiple organ transplantation with careful observation of abdominal signs and abdominal drainage tube, accurate use of somatostatin, nutritional support, maintenance of water and electrolyte balance, and psychological intervention.
ABSTRACT
Objective To explore nursing of the patients with acute myelogenous leukemia after upper abdominal cluster transplantation.Methods From March 2009 to August 2012,eight cases of upper abdominal organ cluster transplantation were performed in our center,among whom one suffered from acute myelogenous leukemia after operation.We summarized the clinical data and nursing methods of this case.Results The leukocytes,erythrocytes and platetets decreased 22 days after transplantation and the decreasing continued for more than four months.Four bone marrow biopsies were performed.During the first two biopsies,no definite cause of the blood cells decreasing was found,while the outcome of the third time showed that it was type M3 acute myeloid leukemia and genetic testing at the fourth time showed AML1/E-TO was positive.After diagnosis,the patient was shifted to the Department of Hematology and underwent further treatment.Conclusions Close observation,timely diagnosis and treatment,prevention of infection,bleeding and psychological nursing are the keys to promote patients recovery.
ABSTRACT
Objective To summarize nursing experience of digestive tract fistula after orthotopic liver transplantation (OLT). Methods From January 2000 to December 2010,1173 patients received liver transplantation,among whom 61 recipients got digestive tract fistula during early stage after operation.The clinical data and major nursing measures of 61 patients were studied retrospectively. Results The incidence rate of digestive tract fistula after OLT was 5.20％.The incidence rate of bile leakage,gastric fistula,duodenal fistula,jejunal fistula,ileal fistula and transverse colon fistula were 3.90％,0.42％,0.08％,0.34％,0.08％ and 0.34％,respectively.The onset time of digestive tract fistula was from 3 to 24 days post transplantation,and atypical symptoms such as fever,abdominal pain,abdominal distention,weakened enterocinesia and even septic shock were presented.And the rising or descending of white blood cells counts,rising of level of transaminase and total bilirubin in laboratory examination were simultaneously presented.Four patients died of bile leakage,and other seven patients died of intestinal fistula throughout conservative or operative treatment.The rest of 50 were discharged healthily. Conclusions The morbidity of digestive tract fistula after OLT is low,but its mortality rate is high.It is necessary to closely observe patients' condition and confirm diagnosis in early stage,in order to promote the healing of digestive tract fistula after OLT.At the same time,psychological,basic and dietary nursing should be given in order to enhance the survival rate and quality of life of patients.