Objective To explore the research hotspots and latest progress of lung transplantation nursing at home and abroad, and to provide reference ideas and directions for the future related research. Methods Through the collection of CNKI and Web of Science core database, the related literature of lung transplantation nursing from inception to December 2023 was retrieved and CiteSpace software was used to focus on keyword co-occurrence, clustering and emergence. Results A total of 352 Chinese literature and 126 English literature were included in this study, and the number of papers published at home and abroad showed an overall upward trend. There were 34 core authors of Chinese literature and 83 core authors of English literature. The core authors led the team to promote research and promote cooperation at home and abroad. At present, the cooperation among research teams needed to be strengthened. Chinese literature keywords included nursing, lung transplantation, extracorporeal membrane oxygenation, lung rehabilitation, lung transplantation surgery, complications. English literature keywords included lung transplanation, quality of life, international society, disease, bone marrow transplantation. There were 15 clusters and 25 emergent keywords in the CNKI database, and 12 clusters and 25 emergent keywords in the Web of Science core database. ConclusionThe study of lung transplantation nursing at home and abroad has been paid more and more attention, and the research is getting more and more sophisticated. The future study can realize the holistic care of patients during perioperative period on the basis of clinical diagnosis and nursing technology, and improve the survival of patients after operation.
ObjectiveTo explore the effect of continuous nursing on lung transplant patients at home based on humanistic care. MethodsAccording to hospitalization order, patients who received lung transplantation in our hospital from January 2016 to October 2020 were divided into a control group and a nursing group. The control group was treated with routine lung transplantation education and regular follow-up after discharge, and the nursing group received humanistic care during follow-up, health education at discharge, cultural exchange activities, and home care plans. After discharge, the self-management ability at home, medication adherence and satisfaction of home care between the two groups were campared. ResultsA total of 60 patients were included in the study. There were 23 patients in the control group, including 16 males and 7 females, with an average age of 58.70±11.00 years. There were 37 pateints in the nursing group, including 25 males and 12 females, with an average age of 57.90±13.20 years. The scores of self-management ability at home of the nursing group (self-concept 27.41±2.37 points vs. 21.78±3.54 points; self-care responsibility 20.73±1.63 points vs. 16.83±2.79 points; self-care skills 41.46±3.77 points vs. 28.26±4.11 points; health knowledge level 57.95±4.10 points vs. 44.87±5.79 points) were higher than those in the control group (all P＜0.05). The medication adherence (7.47±0.46 points vs. 6.87±0.28 points) and satisfaction of home care (23.80±1.20 points vs. 20.50±1.90 points) in the nursing group were higher than those in the control group (both P<0.05). ConclusionContinuous nursing based on humanistic care for lung transplant patients can effectively improve the self-management ability, medication adherence and nursing satisfaction of patients after discharge.
Objective To establish the rat orthotopic liver transplantation model by characterizing the blood supply of hepatic artery with the Cuff skill and the modified arterial sleeve anastomosis, to explore the possible mechanisms of acute rejection and the express of Fractalkine (Fkn) in the early stage after hepatic allograft operation. Methods SD rats were selected as donors and Wistar rats as receptor for the rejection model of orthotopic liver transplantation. Recipient rats were divided into 2 groups randomly after operationand the drugs were given intraperitoneally once a day in each group. In the experimental group, cyclosporine A (CsA) was delivered with 3 mg/kg. In the control group, only normal saline was given with 3 ml/kg. Condition of survivals were observed. The rejection actvity index (RAI) and the expression of Fkn of liver tissue were observed after 3rd, 5th and 7th days in 5 rats. The rest of rats in each group were fed and given drug or normal saline until they were died and the mean survival time were recorded. Results There were 18 survivals in control group, and 19 in experimental group after liver transplantation. Condition of survivals in experimental group was better than that of control group. The mean survival times of experimental group(19.50±4.51 days) was significantly longer than that of control group(7.60±1.60 days), showing statistically significant difference (P＜0.05). After 3rd, 5th and 7th days of transplantation, RAI of control group were 3.80±0.35,5.90±0.87 and 7.50±1.30,respectively;RAI of experimental group were 3.10±0.21,3.90±0.41 and 4.50±0.52.Therewasstatistically significant difference in RAI between 2 groups on the 7th day after transplantation (Plt;0.01). On the 3rd,5th and 7th days after transplantation, the Fkn of control group was 8.20±0.57,21.30±3.30 and 25.70±4.91, and that of experimental group was 8.30±0.56,10.30±0.67 and 11.70±1.23. There were statistically significant differences in Fkn between 2 groups on the 5th, 7th days after transplantation (Plt;0.01). Conclusion Fkn is a participant inacute rejection after the rat orthotopic liver transplantation and can be chosen as a useful target in the diagnosis of acute rejection. CsA has immunosuppressive property in the condition of acute rejection in the rat orthotopic liver transplantation, which may be result from the decreased the level of Fkn.
【Abstract】ObjectiveTo investigate the prophylactic effect of lamivudine monotherapy on the recurrence of hepatitis B after liver transplantation. MethodsThirtyone patients with hepatitis B related benign decompensated cirrhosis who underwent liver transplantation between February 1999 to June 2002 and survived more than 3 months were analyzed retrospectively. Lamivudine was administered to each patient after operation and some patients before operation for the prophylaxis of HBV recurrence. The HBV markers and HBV DNA in serum and bioptic liver tissues in all patients were evaluated before and after operation. ResultsTotal HBV recurrence rate was 19.4％（6/31） during average 38.2 months (3.2-70.2 months) follow up. HBV recurrence rate was 7.1％(2/28), 16.0％(4/25), 26.1％(6/23) and survival rate was 87.1％(27/31), 80.6％(25/31), 66.1％(20.5/31) after 1-, 3-and 5-year, respectively. One hundred milligram lamivudine administration peroral daily for 2 weeks prior to transplantation enable HBeAg 54.5％(6/11) and HBV DNA 50.0％(5/10) positive patients convert to negative respectively. ConclusionPreoperative administration of lamivudine monotherapy can effectively prevent allograft from HBV re-infection after liver transplantation. Lamivudine should be used to convert HBV DNA and HBeAg to negative.
Objective To preliminarily summarize the diagnosis and treatment of coagulopathy in patient with severe hepatic cirrhosis who underwent orthotopic liver transplantation (OLT). Methods Preoperative coagulability, the replacement therapy by coagulation factors and platelet pre-and intraoperatively, intra-operative bleeding amount and blood transfusion amount and the relation to the postoperative course were analyzed retrospectively in 6 patients with severe hepatic cirrhosis who underwent OLT in the last year. Results All of the 6 patients had a Child-c preoperative hepatic function, 2 with prolongation of bleeding time. All of the 6 had a decrease of platelet count, with a mean platelet count of 25.3×１０９／Ｌ. Mean prolongation of prothrombin time was 10.7 seconds as compared with controls. Mean prolongation of activated partial thromboplastin time was 23.1 seconds as compared with controls. Mean fibrinogen was 1.5 g/L. Mean pre- and intra- operative transfusion of fresh frozen plasma was 788 ml, platelet 7.1×１０12， cryopreciptitate 5.5 units, fibrinogen 2.8 grams and lyophilized prothombin complex concentrate (LPCC) 1 700 units. The first 4 cases in the early period had a mean bleeding amount of 8 672.5 ml, with a mean transfusion of 9 215.0 ml. One of the 4 with the most massive intraoperative bleeding was complicated by severe internal milieu disturbance, DIC and fungus infection and died of the infection. Postoperatively the last 2 cases in the late period had a complete preoperative replacement of coagulation factors and platelet and had a only mean bleeding amount of 2 700 ml with a mean transfusion amount of 3 638 ml. Conclusion We initially consider that a preoperative complete replacement of coagulation factors and platelet according to the coagulability tests may lessen intraoperative bleeding and transfusion and make the patient an uneventful postoperative course.
ObjectiveTo compare the effect and safety of basiliximab in ABO incompatible pediatric liver transplant recipients.MethodsABO incompatible pediatric liver transplantation operated between January 2019 and August 2020 were studied. The patients were allocated randomized into two groups. Patients in experimental group were treated with basiliximab as immune induction therapy, but basiliximab was not used in patients of control group. Tacrolimus combined methylprednisolone were used after liver transplantation. The clinical characteristics, graft and recipient survival rate, rejection, infectious complications, and kidney functions after liver transplantation were observed. Donor specific antibody (DSA) was tested in 3 months after liver transplantation. The growth and development were assessed too after liver transplant.ResultsFourty-four patients were enrolled in the study, including 19 patients in the experimental group and 25 patients in the control group. The median follow-up time was 16.6 months (3.8–25.4 months), and there were no statistically differences between the two groups in terms of age, sex, weight, pediatric end-stage liver disease (PELD) score, and other basic conditions. There were no significant differences between the two groups in tacrolimus dose, tacrolimus trough concentration, kidney functions, height and weight growth after liver transplantation. There were no statistical differences in lung infection, blood stream infection within 3 months after liver transplantation, cytomegalovirus, EBV infection, graft/patient survival rate after liver transplantation (P>0.05). However, the acute rejection rate was lower and the DSA positive rate in 3 months after liver transplantation was lower in the experimental group (P<0.05).ConclusionsBasiliximab can be safely used in ABO incompatible pediatric liver transplant recipients. Acute rejection rate and DSA positive rate after transplantation can be decreased with the useof basiliximab.
摘要:目的:总结应用自体真皮片移植疝修补术治疗腹股沟疝20例的近期治疗效果。方法:使用自体真皮片移植,对20例各类腹股沟疝患者进行无张力修补治疗;观察手术方法及时间、手术指征、术后患者自主能力的恢复、术后伤口疼痛、并发症和复发率。结果:与传统疝修补手术相比,自体真皮移植疝修补术具有方法简便、手术指征广、术后疼痛轻、恢复快、并发症少和复发率低的优点。结论:自体真皮移植疝修补术是一项更符合人体解剖结构和疝的病理生理的手术方法,具有传统方法无法比拟的优势。尤其适于在基层医院推广。Abstract: Objective: To summarize the recently therapeutic effect of autodermis transplantation repair of inguinal hernia. Methods: Twenty patients were treated by tension free hernia repair with autodermis transplantation. The operative procedure, surgical indication,ability recovery,postoperative pain,complications and recurrence rate were studied. Results: Autodermis transplantation hernia repair was superior to the traditional because of easier performance,wider indications,blander postoperative pain,faster recovery,fewer complications and lower recurrence. Conclusion: Autodermis transplantation hernia repair is more consistent with human anatomic structure and hernial pathophysiology than the conventional method, especially suiltable for primary hospital.
To introduce a new technique for vascular pedicle elongation in the anterolateral thigh island flap transplantation and evaluate the outcome of this technique in the clinical application. Methods From January 2003 to January 2006, 6 patients (5 males, 1 female; age, 1849 years) were admitted for surgical operation because of the soft tissue defect around the knee joint. The soft tissue defect after the injury was found in 3 patients, the defect after the removal of the softtissue tumor in 1, and the defect after the prosthetic replacement in the knee joint in 2. The soft tissue defects ranged in size of 8 cm×4 cm to 15 cm ×6 cm. When the anterolateral island flap of the thigh underwent the reverse transplantation, the ascending branch of the lateral circumflex femoral artery was used as a nutrient vessel for the flap, and the descending branch of the lateral circumflex femoralartery was separated to the distal part. The main trunk of the lateral circumflex femoral artery was ligated at the point that was proximal to the furcation ofthe ascending and decending branches so that the vessel pedicle of the flap could be lengthened and then the defect was repaired.The flaps ranged in size of 10cm×6 cm to 18 cm×8 cm Results All the flaps were successfullytransferred in the 6 patients. The lengthened pedicle ranged in length from 8 to 12 cm, with an average of 10 cm. There was no vascular crisis after operation. All the transferred flaps survived, with a color and texture similar to those in the recipient site. The postoperative followup for 6-18 months revealed that the motion range of the knees was satisfactory. Conclusion The vascular pedicle elongation technique can enlarge the application scope of the anterolateral thigh island flap and the survival rate of the flap is not influenced by any factor.
Objective To explore the key technique of allogeneic whole pancreaticoduodenal transplantation (WPDT) in rats. MethodsWPDT model was established between Lewis rats as donors and Wistar rats (with type 1 diabetes mellitus) as recipients. End to side anastomosis was performed in abdominal aorta of donors and recipients. The portal vein of the graft was anastomosed with the recipients left renal vein by cuff technique. And side to side anastomosis was made between the graft duodenum and the host jejunum. ResultsForty-four of 50 rats were successfully performed WPDT. Amongthem, 8 rats died in postoperative 3 days, the survival time of residual 36 rats was 6-16 days, with an average of (10.45±3.30) days. The peak of death appeared on day 7-10 after operation. The typical acute rejection in pathological changes were observed on day 7. ConclusionSkilled microsurgical techniques and emphasis on details are important to establish WPDT model.
Objective To investigate the value of monitoring cytokines in serum after human doublehand allotransplantation. Methods We detected solube interleukin-2 receptor(sIL-2R), interleukin-2(IL-2) and interleukin-6(IL-6) levels of the serum in the patient who were performed doublehand transplantation with immunosupressive from September 2000 to November 2000, and in15 healthy volunteers by using enzyme linked immunosorbent assays. Results TheIL-2 and IL-6 levels decreased quickly during inducing period （P＜0.05）, and then increased gradually. While the sIL-2R level increased. The IL-2 level was lower（P＜0.05）, the IL-6 and sIL-2R levels were slightly higher when compared with those before transplantation. There was significant difference in the IL-2level between the patient and healthy volunteers both before and after transplantation, in the IL6 level between the patient and healthy volunteers during inducing period.Conclusion IL-2, IL-6 and sIL-2R levels of serum may be useful in diagnosis of rejection, prevention of opportunistic infection, tumor and graft versus host disease.