Aerobic glycolysis is a unique mark of cancer cells, which enables therapeutic intervention in cancer. Forkhead box K1 (FOXK1) is a transcription factor that facilitates the progression of multiple cancers including hepatocellular carcinoma (HCC). Nevertheless, it is unclear whether or not FOXK1 can affect HCC cell glycolysis. This study attempted to study the effect of FOXK1 on HCC cell glycolysis. Expression of mature miRNAs and mRNAs, as well as clinical data, was downloaded from The Cancer Genome Atlas-Liver hepatocellular carcinoma (TCGA-LIHC) dataset. FOXK1 and miR-144-3p levels were assessed through quantitative real-time polymerase chain reaction (qRT-PCR) and western blot. Targeting of the relationship between miR-144-3p and FOXK1 was verified via a dual-luciferase assay. Pathway enrichment analysis of FOXK1 was performed by Gene Set Enrichment Analysis (GSEA). Cell function assays revealed the glycolytic ability, cell viability, migration, invasion, cell cycle, and apoptosis of HCC cells in each treatment group. Bioinformatics analysis suggested that FOXK1 was upregulated in tissues of HCC patients, while the upstream miR-144-3p was downregulated in tumour tissues. Dual-luciferase assay implied a targeting relationship between miR-144-3p and FOXK1. Cellular experiments implied that silencing FOXK1 repressed HCC cell glycolysis, which in turn inhibited the HCC malignant progression. Rescue assay confirmed that miR-144-3p repressed glycolysis in HCC cells by targeting FOXK1, and then repressed HCC malignant progression. miR-144-3p/FOXK1 axis repressed malignant progression of HCC via affecting the aerobic glycolytic process of HCC cells. miR-144-3p and FOXK1 have the potential to become new therapeutic targets for HCC, which provide new insights for HCC treatment.

目的 探究基于需要层次理论的干预方法对重症胰腺炎患者心理情绪、疾病应对方式的影响.方法选取 2020 年8 月至2021 年8 月收治的重症胰腺炎患者120 例,完全随机法分为对照组和观察组,每组60 例.对照组给予常规护理干预,观察组给予基于需要层次理论的干预方法,观察 2 组疾病应对方式、SAS、SDS、生命质量、GQOLI-74、PSQI、GSES、VAS评分及护理满意率.结果 观察组屈服、回避低于对照组,面对高于对照组,差异有统计学意义(P<0.05).观察组SAS、SDS评分低于对照组,差异有统计学意义(P<0.05).观察组生命质量评分高于对照组,差异有统计学意义(P<0.05).观察组GQOLI-74、PSQI评分高于对照组,差异有统计学意义(P<0.05).观察组GSES高于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05).观察组护理满意率高于对照组,差异有统计学意义(P<0.05).结论 基于需要层次理论的干预方法对重症胰腺炎患者进行干预,可有效改善患者疾病应对方式、生命质量、生活质量、自我效能及睡眠质量,降低其抑郁、焦虑情绪,提升护理满意度.

Objective: The primary purpose of this study was to explore the safety of peripheral intravenous catheter (PIVC) replacement every 96 h compared to that of clinically indicated catheter removal. Methods: A prospective, single-blind, randomized controlled trial was conducted. A random number table method was used. Six hundred patients treated with PIVC intravenous infusion in 10 nursing units of a hospital from September to October 2019 were selected. Sixty were collected from each nursing unit, including 30 in the clinically indicated replacement group and 30 in the routine replacement group. The incidence of phlebitis, catheter-related infection (CRI), occlusion, infiltration, and any form of infusion therapy failure were compared between the two groups. SPSS 23.0 software was used. Results: The dwelling times of PIVC in the clinically indicated replacement group and routine replacement group were significantly different (hours) (83.62 ± 50.08, 69.75 ± 25.54, t = 3.021, p = 0.003). The incidence of any form of infusion therapy failure (RR = 4.448, 95% CI: 3.158–6.265, p < 0.001), phlebitis (RR = 2.416, 95% CI: 1.595–3.660, p < 0.001), occlusion (RR = 6.610, 95% CI: 3.062–14.268, p < 0.001), infiltration (RR = 2.607, 95% CI: 1.130–6.016, p = 0.020), accidental dislodgement (RR = 2.027, 95% CI: 1.868–2.200, p = 0.013), and pain at the insertion site (RR = 2.521, 95% CI: 1.742–3.649, p < 0.001) was higher in the clinically indicated replacement group than that in the routine replacement group. The overall survival curve of PIVC was drawn with Kaplan–Meier survival analysis. The median survival time of intravenous infusion was 59.58 h; the cumulative survival rates of 48 h, 72 h, and 96 h were 77.00%, 51.33%, and 20.33%, respectively. Conclusion: Replacement of PIVC every 96 h is safer than clinically indicated.

Abstract Background Both midline catheters (MCs) and peripherally inserted central catheters (PICCs) can cause venous thromboembolism (VTE), but the prevalence associated with each is controversial. Objective To compare the risk of VTE between MCs and PICCs with a systematic review and meta‐analysis. Methods The Web of Science Core Collection, PubMed, Scopus, Embase, the Cochrane Library and ProQuest were searched from inception to January 2020. All studies comparing the risk of VTE between MCs and PICCs were included. Selected studies were assessed for methodological quality using the Downs and Black checklist. Two authors independently assessed the literature and extracted the data. Any different opinion was resolved through third‐party consensus. Meta‐analyses were conducted to generate estimates of VTE risk in patients with MCs versus PICCs, and publication bias was evaluated with RevMan 5.3. Results A total of 86 studies were identified. Twelve studies were recruited, involving 40,871 patients. The prevalence of VTE with MCs and PICCs was 3.97% (310/7806) and 2.29% (758/33065), respectively. Meta‐analysis showed that the prevalence of VTE with MCs was higher than that with PICCs (RR=1.53, 95% CI: 1.33–1.76, p < .00001). Subgroup analyses by age showed that the prevalence of VTE with MCs was higher than that with PICCs in the adult group (RR=1.75, 95% CI: 1.38–2.22, p < .00001), and higher than that with PICCs in the other subgroups (RR=1.42, 95% CI: 1.19–1.69, p = .0001). Subgroup analyses by nation showed that the prevalence of VTE with MCs was higher than that with PICCs (RR=1.50, 95% CI: 1.30–1.73, p < .00001) in US subgroup and higher than that with PICCs (RR=2.87, 95% CI: 1.24–6.65, p = .01) in the other nations. The sensitivity analysis shows that the results from this meta‐analysis are robust and all studies have no significant publication bias. Conclusions This study provides the first systematic assessment of the risk of VTE between MCs and PICCs. MCs are associated with a higher risk of VTE than PICCs in all patients and adults. The findings of this study have several important implications for future practice. However, the risk of VTE between MCs and PICCs in children is unclear.

目的 了解新入职规范化培训护士的真实工作体验,使护士管理者更能关注、理解新入职护士的工作状态,为其提供参考依据,从而运用科学的、人性化的管理方法,促使新入职规范化培训护士能以更快、更好的状态适应工作.方法 采用质性研究中的现象学研究法,以面对面、半结构式深度访谈的方式收集资料,对西安交通大学第一附属医院2016年150名新入职规范化培训护士采用目的抽样法抽取的12名护士进行研究,对访谈内容进行记录与归纳,运用Colaizzi七步分析法形成一定的主题.结果 新入职护士工作体验共提炼出5个主题:专科知识、技能得到全面提高;压力和恐惧;没有归属感;经验不足;愧疚.结论 规范化培训可增强新入职护理护士综合素质,但应该关注规范化培训护士的心理疏导,营造团队环境,有助于他们平稳度过规范化培训期.

目的 系统回顾成人睡眠时间与2型糖尿病(T2DM)相关性横断面研究,通过Meta分析睡眠时间长短与T2DM发生危险性,为预防与控制T2DM提供依据.方法 计算机检索PubMed、Web of science、Scopus、Embase、Cochrane Library、中国知网、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库,检索时间为建库至2020年4月,收集睡眠时间与T2DM之间相关性横断面研究,由两位研究者按照纳入与排除标准独立检索、筛选文献、质量评价与提取资料.利用RevMan 5.3进行Meta分析、发表偏倚分析等.结果 共纳入26篇研究,342928例研究对象,T2DM现患率短睡眠时间(SSD,t≤6 h)为9.84％、正常睡眠时间(NSD,t>6～<9 h)为6.41％、长睡眠时间(LSD,t≥9 h)为9.90％.Meta分析显示,SSD、LSD组T2DM患病风险比NSD组明显增加(RR=1.49,95％CI:1.35～1.64,P<0.001;RR=1.45,95％CI:1.33～1.58,P<0.001).各研究间敏感性稳定,发表偏倚小.结论 SSD或LSD均可增加T2DM发病风险.

目的 分析针对重型新型冠状病毒肺炎的基本护理措施及针对性护理对策,以期为后续相似病例及临床症状提供护理实践参考.方法 对西安交通大学第一附属医院发热病房2020年1月24日至3月10日收住的4例新型冠状病毒肺炎患者(3例重型、1例危重型)的临床诊疗资料进行回顾性分析,着重分析并整理患者在治疗过程中采取的基本护理措施及针对性护理措施.结果 经及时诊治及护理,3例重型患者均已治愈出院,1例危重型患者病情明显好转.分析护理措施可知,护理人员首先应做好完善的自我防护,同时需积极有效地消除并隔离传染源,密切观察患者的病情变化,遵医嘱根据患者的症状给予针对性的护理,促进患者康复.结论 对重型新型冠状病毒肺炎患者给予针对性的护理措施有利于改善其临床症状与体能的恢复.

目的:分析肝胆外科病区噪声的主要来源,探讨噪声对病人的不利影响,并提出相应的护理对策.方法:利用噪声测定仪分别测定了肝胆外科病区内噪声在1 d内的分布特点以及各种噪声源产生的噪声强度;同时调查了200例肝胆外科Ⅲ级手术病人对病区噪声的了解、评价,及噪声对病人的影响.结果:病区昼夜间噪声水平均超过规定标准.06:00～10:00护士站平均噪声强度最大,可达82.8 dB;产生噪声强度最大的噪声源分别是呼叫器铃声和医护人员的谈话声.病人认为主要的噪声源分别是谈话声,其次是仪器声、物品碰撞声.噪声可致76.5％的病人出现一些神经系统的症状;53.0％的病人可出现体倦乏力,不愿下床活动;37.0％ 的病人可出现心悸、胸闷、气短;35.5％的病人出现一些消化系统症状.结论:病区噪声对手术病人的生理及心理可产生明确的危害,严重影响病人术后的康复,应采取相应的护理对策,从而降低噪声和保护病人.

Objective To study the association between sleep duration and the incidence of type 2 diabetes mellitus (T2DM) and to provide a theoretical basis for the prevention of T2DM through a meta-analysis. Methods PubMed, Web of Science, Scopus, Embase, Cochrane Library, ProQuest, CNKI, Wanfang, VIP, and SINOMED were searched from their inception until May 2020. All cohort studies on the relationship between sleep duration and T2DM in adults were included. According to the inclusion and exclusion criteria, two authors independently assessed the literature and extracted the data. Metaregression and publication bias were evaluated, and sensitivity and meta-analyses were conducted with RevMan 5.3. Results A total of 17 studies were collected, involving 737002 adults. The incidence of T2DM was 4.73% in short sleep duration (SSD) (t ≤ 6 h), 4.39% in normal sleep duration (NSD) (6 h < t < 9 h), and 4.99% in long sleep duration (LSD) (t ≥ 9 h). The meta-analysis demonstrated that SSD increased the risk of T2DM compared with NSD (RR = 1.22, 95% CI: 1.15-1.29, P < 0.001), LSD increased the risk of T2DM compared with NSD (RR = 1.26, 95% CI: 1.15-1.39, P < 0.001), and the risk of T2DM has no significant difference between SSD and LSD (RR = 0.97, 95% CI: 0.89-1.05, P = 0.41). The sensitivity of each study was robust and the publication bias was weak. Conclusion SSD or LSD can increase the risk of T2DM.

目的 探讨应用循证护理措施预防重症急性胰腺炎(SAP)留置中心静脉导管患者感染的效果,为临床采取更为有效的护理方法 提供参考依据.方法 选取某三甲医院2017年3月—2019年3月收治的112例需中心静脉置管的重症急性胰腺炎患者为研究对象.采用随机数字表法将其分为对照组与干预组,每组各56例.对照组采取常规护理,干预组采取以证据为基础的循证护理.对比分析两组患者在中心静脉置管后第7天、第14天的留置导管感染发生率及穿刺点皮肤不良反应发生率.结果 采用以证据为基础的循证护理后,干预组置管后第7天、第14天中心静脉留置导管感染(CVC-RI)发生率为3.57％、8.93％,明显低于对照组的14.29％、30.36％,穿刺点皮肤不良反应发生率(14.29％)也低于对照组(39.29％),差异均有统计学意义(P<0.05).结论 采取以证据为基础的循证护理可以预防重症急性胰腺炎留置中心静脉导管患者感染的发生,降低SAP患者中心静脉导管的感染率和穿刺点皮肤不良反应的发生率,值得在临床广泛推广.

目的 探讨鄂尔多斯地区蒙古族高血压前期人群健康行为状况及其影响因素,为高血压三级预防提供依据.方法 研究采用横断面调查研究方法 ,利用目的抽样法选取内蒙古鄂尔多斯市10个社区蒙古族高血压前期居民作为研究对象,采用一般资料调查表、健康促进生活方式量表中文修订版收集数据,SPSS 23.0统计分析.结果 共调查302例蒙古族高血压前期患者,健康行为总分(108.65±21.19)分.影响因素分析显示蒙古族高血压前期人群健康行为的影响因素为婚姻状况、职业、医疗费用承担方式、是否吸烟、是否有高血压家族史,已婚健康行为低于未婚者(β=-9.746,95％CI:-18.918～-0.573),医务人员健康行为高于其他(包括无业)(β=19.697,95％CI:5.772～33.622),行政管理人员健康行为高于其他(包括无业)(β=26.132,95％CI:12.418～39.846),城镇居民医疗保险人员健康行为高于其他(自费)(β=12.587,95％CI:0.874～24.300),农村居民医疗保险人员健康行为高于其他(自费)(β=16.722,95％CI:4.436～29.008),不吸烟人员健康行为高于吸烟(β=13.407,95％CI:6.758～20.056),无高血压家族史人员健康行为低于高血压家族史(β=-17.400,95％CI:-27.418～-7.382).结论 蒙古族高血压前期人群健康行为影响因素为婚姻状况、职业、医疗费用承担方式、是否吸烟、是否有高血压家族史.

AbstractBackgroundBoth midline catheters (MCs) and peripherally inserted central catheters (PICCs) can cause catheter‐related bloodstream infection (CRBSI), but the prevalence associated with each is not clear.ObjectiveTo compare the risk of CRBSI between MCs and PICCs with a meta‐analysis.MethodsThe Web of Science Core Collection, PubMed, Scopus, Embase, The Cochrane Library and ProQuest were searched. All studies comparing the risk of CRBSI between MCs and PICCs were included. Selected studies were assessed for methodological quality using the Downs and Black checklist. Two authors independently assessed the literature and extracted the data. A fixed effects model was used to generate estimates of CRBSI risk in patients with MCs versus PICCs. Publication bias was evaluated, and meta‐analyses were conducted with RevMan 5.3.ResultsA total of 167 studies were identified. Ten studies were collected, involving 33,322 patients. The prevalence of CRBSI with MCs and PICCs was 0.58% (40/6,900) and 0.48% (127/26,422), respectively. Meta‐analysis showed that the prevalence of CRBSI was not significantly different between MCs and PICCs (RR = 0.77, 95% CI: 0.50–1.17, p = .22). While the result showed that the prevalence of CRBSI with MCs was lower than that with PICCs (RR = 0.55, 95% CI: 0.33–0.92, p = .02) after poor‐quality studies were removed. The sensitivity analysis shows that the results from this meta‐analysis are fair in overall studies and non‐poor‐quality studies. All studies have no significant publication bias.ConclusionsThis study provides the first systematic assessment of the risk of CRBSI between MCs and PICCs and provides evidence for the selection of appropriate vascular access devices for intravenous infusion therapy in nursing. The prevalence of CRBSI was not significantly different between them.

目的 运用信息计量学和信息可视化理论对我国院外急救中文文献可视化分析,探究我国院外急救研究现状及研究热点.方法 应用"院外急救""院前急救"主题词检索CNKI建库至2020年1月20日收录的所有期刊文献资料,采用信息可视化软件CiteSpace 5.3与VOSviewer 1.6对学术文献的作者、机构、关键词节点等信息进行时序分析、协作网络分析、共现分析、聚类分析、突现词分析.结果 共检索到9090篇院外急救中文文献,发表时间分布在1986—2020年,1986—2000年发表论文数量呈现缓慢增长趋势;2001—2011年发表论文数量呈现快速增长趋势;2012至今发表论文数量呈现缓慢下跌至稳定趋势.论文作者共计12661人,其中2956人论文数量在2篇及以上.论文数量最多的10位作者大部分拥有合作团队.论文发表机构/部门数共计3827,发表论文数量前十位的机构/部门大部分位于东部地区.院外急救相关论文共10839个关键词,其中535个关键词出现频次超过10次,"护理""患者""急性心肌梗死""预后""心肺复苏""救护车""心脏骤停""脑出血""颅脑损伤""脑卒中"等词出现频率位居前十位.关键词聚类共形成"急救中心""急性心肌梗死""急救""心脏骤停""院外死亡"5个主要知识图谱.突现词分析展示历年研究重点的演变,近年关注的重点有高血压脑出血、安全转运、抢救成功率、急性脑出血、满意度、并发症、心搏骤停、院外急救护理路径、临床疗效等.结论 信息计量学和信息可视化理论可以帮助发现院外急救的研究现况、研究进展与研究热点.

目的 探讨套管法在更换鼻肠管中的临床应用效果,为更换鼻肠管提供一种新方法.方法 于2015年5月至2019年12月选取西安交通大学医学院第一附属医院肝胆外科需更换鼻肠管的11例患者作为研究对象.采用套管法的方式完成鼻肠管的更换.结果 10例患者成功完成鼻肠管的更换,更换成功率为90.91％;更换过程中患者均未出现黏膜出血、呛咳及误吸等并发症.结论 借助套管法更换鼻肠管,更换成功率高,且更换过程安全、操作简单、患者痛苦小,值得临床推广应用.

目的 调查蒙古族高血压前期人群健康信念与健康行为状况,并探讨健康信念与健康行为的相关性.方法 采用目的抽样法选取内蒙古鄂尔多斯市10个社区302例蒙古族高血压前期人群,利用一般资料调查表、Champion健康信念量表、健康促进生活方式量表进行问卷调查,EpiDate 3.1建立数据库,SPSS 23.0进行统计描述与推断.结果 调查302例高血压前期人群,健康信念总分(167.18±31.46)分,各维度得从高到低依次为感到有实施能力、个人健康信念、感到有控制力、感到有威胁、感到资源利用.健康行为总分(108.65±21.19)分,各维度得分从高到低依次为:体育运动、人际关系、精神成长、健康责任、营养、健康压力管理.蒙古族高血压前期人群健康信念总分与健康行为总分(r=0.283)呈正相关.结论 蒙古族高血压前期人群健康信念与健康行为呈正相关.

目的 分析外科重症监护室(SICU)患者非计划重返的原因和预后.方法 选取2015年1月至2019年10月我院SICU出室后重返的4738例患者临床资料进行分析.结果 共纳入SICU非计划重返患者109例,重返率为2.3％.早重返组以肺部感染/呼衰为主,晚重返组以腹腔出血和肺部感染/呼衰为主.低评分组的死亡率为3.3％(2/61),显著低于高评分组的16.7％(8/48),差异具有统计学意义(P<0.05).结论 呼吸系统和手术相关并发症是导致SICU患者非计划重返的重要原因,重返患者预后较差,APACHEⅢ评分可以作为预判死亡的重要手段.

目的 探讨运用塞丁格技术原理置入鼻肠管的临床应用效果.方法 选择西安交通大学第一附属医院肝胆外科2018年1月至2019年12月留置鼻肠管的患者64例,随机分为两组,试验组32例,对照组32例.对照组运用常规的"徒手盲插法"或"超声引导法"置入鼻肠管,试验组运用赛丁格技术原理先给患者留置一根修剪过的胃管,再从胃管内部运用"徒手盲插法"或"超声引导法"留置鼻肠管.观察比较两组患者置管时间,鼻肠管重置次数,置管过程鼻咽部黏膜出血情况,患者心率、血压的变化,以及操作过程患者的满意度.结果 置管时间试验组(13.16±3.29)min、对照组(20.00±3.76)min,导管调整次数试验组(2.09±1.08)次、对照组(3.03±0.97)次,试验组均明显低于对照组(P＜0.01).导管重置发生率试验组6％(2/32)、对照组31％(10/32);鼻咽部黏膜出血发生率试验组3％(1/32)、对照组25％(8/32),试验组均明显低于对照组(P＜0.05).操作过程中患者的平均恶心次数试验组(0.94±0.56)次、对照组(2.97士1.15)次;呕吐的发生率试验组3％(1/32)、对照组47％(15/32);心率的变化值试验组(22.28±7.31)次/分、对照组(32.50±8.27)次/分;动脉压变化值试验组(3.94±2.21)mm Hg,对照组(10.66±5.20)mm Hg,试验组均明显低于对照组(P＜0.01).患者满意度试验组(93％)高于对照组(41％),差异有统计学意义(P＜0.01).结论 运用塞丁格技术原理留置鼻肠管可以改善危重患者置管过程的舒适度,降低导管重置发生率,缩短置管时间,降低黏膜出血发生率,利于危重患者心率、血压的稳定,提高患者的满意度,值得临床推广使用.

目的 基于文献计量学、知识图谱理论分析中等长度导管(midline catheters,MC)临床应用进展,探究MC研究现状及研究热点.方法 使用MC英文主题词检索Web of Science核心合集创库至2019年12月31日收录的文献资料,利用CiteSpace与VOSviewer实现MC研究时空分析、关键词聚类分析、密度分析、突现分析、双图叠加分析,绘制知识图谱.结果 共检索出811项MC研究,发表时间分布在1989至2019年,近年研究呈上涨趋势,研究主要分布在美国及欧洲等地区.MC研究可视化显示、置管操作、并发症管理等是主要研究方向,儿童、超声显像、穿刺置管是当下研究热点.施引主要集中在医疗、临床类期刊,被引主要集中在健康管理、护理、医疗类期刊.结论 MC主要研究方向为可视化显示、置管操作、并发症管理等,儿童、超声显像、穿刺置管是研究热点.

目的 通过Meta分析探究中等长度导管(MC)与经外周静脉穿刺中心静脉置管(PICC)静脉输液治疗导管相关血流感染(CRBSI)发生率,以期为临床静脉输液治疗过程防治CRBSI提供参考.方法 检索Web of Sci-ence、PubMed、Scopus、Embase、Cochrane Library、ProQuest、CNKI、万方、维普、CBM数据库,收集MC与PICC发生的CRBSI相关研究,检索时间均为建库至2020年1月.由两名研究者按照纳入与排除标准独立检索、筛选文献、质量评价与提取资料,应用RevMan 5.3软件进行分析.结果 最终纳入文献15篇,共计34235例患者,MC组CRBSI发生率为0.58％(43/7392),PICC组CRBSI发生率为0.53％(142/26843),Meta分析显示MC组CRB-SI发生率低于PICC组(RR=0.63,95％CI=0.43～0.93,P=0.02).除其他国家亚组MC组CRBSI发生率与PICC组差异无统计学意义(P>0.05)外,中国亚组MC组CRBSI发生率低于PICC组(RR=0.21,95％CI=0.07～0.64),美国亚组MC组CRBSI发生率低于PICC组(RR=0.53,95％CI=0.31～0.89),英国亚组MC组CRBSI发生率高于PICC组(RR=3.67,95％CI=1.18～11.37),差异均有统计学意义(均P<0.05).成人亚组、其他亚组MC组CRBSI发生率与PICC组比较,差异均无统计学意义(均P>0.05).随机对照研究亚组MC组CRBSI发生率低于PICC组[(RR=0.12,95％CI=0.02～0.66),P=0.01],回顾性队列研究亚组MC组CRBSI发生率与PICC组比较,差异无统计学意义(P>0.05).总体各研究间稳定性一般,质量良好和中等研究间稳定性好,无明显发表偏倚.结论 首次对MC与PICC发生CRBSI风险进行系统评价与Meta分析,静脉输液治疗过程中MC组CRBSI发生率低于PICC组,在同等条件下可考虑优先选择MC为患者进行静脉输液治疗.仍需更多高质量及儿童相关研究进一步评估、探究MC与PICC发生CRBSI的风险.

目的 总结胆道闭锁患儿肝移植术后并发症的观察及护理要点,并推广护理经验.方法 对4例胆道闭锁患儿行肝脏原位植入术术后血管并发症、感染的预防及控制、消化道瘘及术后营养支持、胆道并发症等的观察和针对性护理措施进行分析,总结护理经验.结果 1例患儿术后出现感染症状,给予动态调整抗感染方案,落实保护性隔离措施,顺利出院.1例患儿术后出现了消化道瘘,经过手术及营养支持,严密观察治疗后消化道功能逐渐恢复,经过积极治疗护理,顺利康复出院.4例患者出院后随防至术后1年,无其他严重并发症.结论 胆道闭锁患儿肝移植术后在做好常规围手术期管理的基础上,重视患儿术后血管并发症、感染、消化道瘘等并发症的观察护理,同时根据患儿术中情况,个体差异等特例,预警可能出现并发症,改善肝移植患儿预后,促进患儿康复.