Bernard O, Houssin D, Valayer J
Bicêtre-Cochin pour la transplantation hépatique chez l'enfant: Hôpital Cochin.
Arch Fr Pediatr. 1988;45 Suppl 1:749-54.
From a practical point of view, the care of a child after liver transplantation comprises 3 periods with decreasing severity: -the first one takes place in the intensive care unit: immunosuppression is started with steroids, azathioprine and cyclosporine and four major complications are sought for and treated: primary graft dysfunction, acute rejection, hepatic artery thrombosis and infection; -the second period takes place in conventional hospital settings: cyclosporine is progressively switched from IV to oral; rejection, cytomegalovirus infection and biliary complications are sought for and treated; -the third period takes place at home: the level of immunosuppression is progressively lowered under biochemical supervision; long-term complications (renal and malignancies) are detected.
从实际角度来看,儿童肝移植后的护理包括三个严重程度逐渐降低的阶段:第一个阶段在重症监护病房进行:开始使用类固醇、硫唑嘌呤和环孢素进行免疫抑制治疗,并查找和治疗四大并发症:原发性移植物功能障碍、急性排斥反应、肝动脉血栓形成和感染;第二个阶段在常规医院环境中进行:环孢素逐渐从静脉注射改为口服;查找和治疗排斥反应、巨细胞病毒感染和胆道并发症;第三个阶段在家中进行:在生化监测下逐渐降低免疫抑制水平;检测长期并发症(肾脏问题和恶性肿瘤)。