Abstract:

Objective To evaluate the effect of perioperative nursing intervention for renal transplant recipients based on dynamic volume management assessment. Methods A retrospective analysis was conducted on 112 adult renal transplant recipients who underwent deceased donor renal transplantation in Shanxi Provincial Second People's Hospital from January 2024 to June 2025， with complete preoperative and postoperative data. All recipientsreceived a full-course dynamic assessment-based volume management nursing intervention model， which included the following components: re-evaluation of the basic volume status to adjust the appropriate dry weight， conduction of24 h preoperative weight monitoring to provide baseline data， and performance of dynamic assessment postoperatively by combining vital signs， auxiliary examinations， and impedance cardiography. Results Dynamic assessment-basedvolume management reduced perioperative complications after renal transplantation. Within 7 days postoperatively，the incidence rates of acute coronary syndrome， acute pulmonary edema， congestive heart failure， delayed graft function andintestinal obstruction were 3.6% （4/112 cases），0.9% （1/112 cases），3.6% （4/112 cases），17.9% （20/112 cases） and 3.6% （4/112 cases）. Except for one new case of congestive heart failure that occurred after 7 days， all other complicationsoccurred within 7 days. Conclusion Dynamic volume assessment （dominated by impedance cardiography） is beneficial for fluid management in kidney transplantation and reduces perioperative complications. 

Key words:

 , Kidney transplantation； , Impedance Cardiography； , Dynamic volume management； , Complications

摘要：

目的 评价基于动态评估肾移植容量管理护理干预对肾移植围手术期受者的影响。方法 回顾性分析 2024 年 1 月至 2025 年 6 月在山西省第二人民医院行遗体捐献肾移植且术前、术后数据完整的 112 例成人肾移植受者作为受试对象，给予贯彻移植全程动态评估容量管理护理干预模式，包括 ：术前入院时基本容量状态评估重新调整适宜干体重，术前 24 h 内体重监测为术后干体重的评估提供基线数据，术后根据生命体征、辅助检查与电阻抗无创心功能监测结合使用进行动态评估。结果 动态评估容量管理减少肾移植后围手术期并发症，其中术后 7 d 内，急性冠脉综合征、急性肺水肿、充血性心力衰竭、移植肾功能延迟恢复、肠梗阻发生率分别为 3.6%（4/112 例）、0.9%（1/112 例）、3.6%（4/112 例）、17.9%（20/112 例）、3.6%（4/112 例）。 除充血性心力衰竭 7 d 后新发生 1 例，余并发症均发生于术后 7 d。结论 动态容量评估（以电阻抗无创心功能监测为主导）有利于肾移植手术的液体管理，减少围手术期并发症发生。

关键词:

 , 肾移植 ； 电阻抗无创心功能监测 ； 动态容量管理 ； 并发症