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 ,

摘要：

目的 探讨围手术期液体管理对肝移植术后肺部并发症（postoperative pulmonary complications，PPCs）的影响，并分析护理干预在改善预后中的作用。方法 回顾性分析 2023 年 1 月至 2024 年 12 月在吉林大学第一医院接受肝移植的 269 例患者，根据术后 7 d 内是否发生 PPCs，分为 PPCs 组（n ＝ 147）和非 PPCs 组（n ＝ 122）。比较两组的术前基线资料、术中液体输入量、出血量及血制品输注量、术后 24 ~ 72 h 累积液体平衡、气管插管时间，并结合护理干预措施进行分析。结果 PPCs 组患者术中液体输入量、血制品输注量及出血量均高于非 PPCs 组（P ＜ 0.05）。术后 24 ~ 72 h 累积液体平衡持续为正，尿量较低。与之相比，非 PPCs 组部分患者在术后 48 ~ 72 h阶段已接近液体负平衡。PPCs组患者气管插管时间明显延长（P＜ 0.01）。回顾性资料显示，护理团队通过动态监测、精细化液体调控、药物管理和呼吸支持等干预措施，在液体管理安全性和并发症防控中发挥了积极作用。结论 围手术期液体过量输入及持续液体潴留是肝移植术后 PPCs 的重要危险因素。围手术期液体治疗结合规范化、精细化的护理干预有助于实现液体平衡，减少肺部并发症，改善患者术后恢复质量和预后。

关键词:

肝移植 , 液体管理 , 肺部并发症 , 围手术期护理