总结了1例早期移植物功能障碍患者在接受体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）支持后再次进行心脏移植的护理经验。护理要点包括：在移植物功能障碍期间，协同管理大循环与微循环，严格执行ECMO转运安全核查，并精准调控出凝血平衡，确保患者血流动力学稳定与治疗安全；再次移植后，通过渐进式呼吸训练、分阶段康复以及个体化营养支持，促进患者功能恢复，同时加强免疫抑制管理与感染防控，构建“患者-置管部位-环境”三维防护屏障。经积极救治与精心护理，患者在ICU住院45 d后顺利转入普通病房，术后第169天康复出院。

The nursing experience of a patient with early allograft dysfunction (EAD) who underwent a heart re-transplantation supported by extracorporeal membrane oxygenation (ECMO) was summarized.Key nursing care points in the graft dysfunction phase included implementing coordinated management of systemic and microcirculation,conducting ECMO transport safety checks,and precisely regulating the coagulation-anticoagulation balance to maintain hemodynamic stability and ensure treatment safety.Key nursing care points after the re-transplantation phase included promoting functional recovery through progressive respiratory training,phased rehabilitation,and individualized nutritional support,while reinforcing immunosuppressive management and infection control to establish a three-dimensional protective barrier of patient-catheter site-environment.After active treatment and meticulous care, the patient was successfully transferred to a regular ward after 45 days in the ICU and was discharged on the 169th day after the operation.

R473.6

浙江省医药卫生科技计划（2025KY794）