Bates Eleanor, Martin Daniel
Specialty Registrar, Royal Free Perioperative Research Group, The Royal Free NHS Foundation Trust, London.
Senior Lecturer in Perioperative and Critical Care Medicine, Royal Free Hospital, London NW3 2QG, and Division of Surgery and Interventional Science, University College London, London.
Br J Hosp Med (Lond). 2017 May 2;78(5):273-277. doi: 10.12968/hmed.2017.78.5.273.
The postoperative management of patients immediately after liver transplantation requires knowledge of this complex surgery and the physiology that accompanies liver failure. A multidisciplinary approach to the care of these patients is essential in order to reduce postoperative complications and preserve function in the transplanted organ. By their nature, patients undergoing liver transplantation have complicated medical problems before surgery which must be borne in mind when managing them after surgery. Haemorrhage, haemodynamic instability, acute renal failure, hepatic artery thrombosis and primary graft non-function are some of the complications that clinicians must be prepared for in the first days after transplantation. Pre-empting complications and acting rapidly to overt them is likely to have a considerable positive impact in these patients.
肝移植术后患者的即刻管理需要了解这一复杂手术以及伴随肝衰竭的生理学知识。采用多学科方法护理这些患者对于减少术后并发症和维持移植器官功能至关重要。由于其自身特点，接受肝移植的患者术前存在复杂的医疗问题，术后管理时必须牢记这一点。出血、血流动力学不稳定、急性肾衰竭、肝动脉血栓形成和原发性移植肝无功能是临床医生在移植后最初几天必须应对的一些并发症。预防并发症并迅速采取行动加以克服，可能会对这些患者产生相当大的积极影响。
