关键词:

肝移植 , 液体管理 , 肺部并发症 , 围手术期护理

Abstract:

Objective To investigate the impact of perioperative fluid management on postoperative pulmonary complications （PPCs） following liver transplantation and to evaluate the role of nursing interventions in improving patient outcomes. MethodsA retrospective analysis was performed on 269 patients who underwentliver transplantation between January 2023 and December 2024 in the First Hospital of Jilin University. Patients were classified into a PPCs group （n ＝ 147） and a non-PPCs group （n ＝ 122） based on the occurrence of PPCs within 7 d postoperatively. Preoperative baseline characteristics， intraoperative fluid administration， blood loss， blood product transfusion， cumulative fluid balance within 24 ~ 72 h after surgery， duration of endotracheal intubation were compared between the two groups. In addition， nursing interventions were analyzed. ResultsIntraoperative fluid administration， blood product transfusion， and blood loss were significantly higher in the PPCs group than in the non-PPCs group （P ＜ 0.05）. Cumulative fluid balance remained positive， and urine output was lower 24 ~ 72 h postoperatively. In contrast， some patients in the non-PPCs group approached a negative fluid balance 48 ~ 72 h after surgery. Patients inthe PPCs group had significantly longer intubation duration （P ＜ 0.01）. Retrospective data indicated that the nursingteam contributed positively to fluid management safety and complication prevention through interventions such as dynamic monitoring， refined fluid regulation， medication management， and respiratory support. ConclusionExcessive perioperative fluid administration and sustained fluid retention are major risk factors for PPCs after liver transplantation. The combination of perioperative fluid therapy and standardized， refined nursing interventions has been demonstrated to facilitate the achievement of fluid balance， reduce the incidence of pulmonary complications， and enhance the quality of postoperative recovery and prognosis. 

Key words:

Liver transplantation ； , Fluid management ； , Postoperative pulmonary complications ； , Perioperative ,