Nursing of twice bleeding in abdominal cavity after liver transplantation
10.3760/cma.j.issn.1674-2907.2011.33.009
- VernacularTitle:肝移植术后二次腹腔大出血患者的护理
- Author:
Qiu-Jiang DOU
1
;
Xiao-Feng HE
;
Hai-Dan YE
;
Quan QIAN
;
Jian ZHOU
Author Information
1. 中山大学附属第一医院
- Keywords:
Liver transplantation;
Bleeding in abdominal cavity;
Anticoagulation
- From:
Chinese Journal of Modern Nursing
2011;17(33):3995-3997
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influence of therapy combined with clopidogrel hydrogen sulphate,aspirin and alprostadil on coagulation function of patients after liver transplantation.Methods Summarize the clinical data and therapeutic measures of twice postoperatively bleeding in abdominal cavity for one case underwent liver transplantation in our hospital and administered with clopidogrel hydrogen sulphate and aspirin for 14 years in preoperative period,and alprostadil was added in peri-operative period.Results The operation was successful,and the lost blood was 200 ml.The abdominal drainage were bright red,the volume ＞ 100 ml/h,on postoperative 2 days.The exploratory celiotomy were performed at 36 hours after operation,1500 ml of blood clot were removed,and active bleeding point was not observed.The abdominal drain tube were removed,the normal diet and normal liver function were recovered,on postoperative 4,7 and 14 days,respectively.The clinical manifestation of acute hemorrhagic shock were recurred on postoperative 17 days,and the emergency diagnostic doppler ultrasound test were performed and revealed excessive effusion in abdominal cavity,and then the second opening were performed,and confirmed that a branch of gastro-duodenal artery were bleeding point,3 000 ml of blood clot removed,and one month after liver transplantation the patient recovered and discharged.Conclusions Combining clopidogrel hydrogen sulphate and aspirin for long-term anticoagulation can influence the coagulation function.Close observation after transplantation and knowing clearly patient' s condition on time can provide evidence for diagnosis.Effective treatment should be carried out for saving.Enhancing protective segregation and individual mental nursing can promote patients' recovery.
