小儿长段型先天性巨结肠术前洗肠的护理改进
|
摘要
目的探讨小儿长段型先天性巨结肠术前洗肠的护理改进。方法 82例长段型巨结肠患儿随机分为对照组和观察组,每组41例。对照组按照标准医学流程进行护理以及手术,观察组应用术前洗肠护理改进方法进行灌肠,按照常规手术流程治疗。评价2组平均灌肠液用量、术中出血量、术后肠蠕动恢复时间以及平均灌肠时间。结果观察组平均灌肠液用量以及平均灌肠时间所需时间优于对照组(P<0.05)。观察组术中出血量及术后肠蠕动恢复时间优于对照组,但差异无统计学意义(P>0.05)。观察组手术时间以及住院时间明显优于对照组(P<0.05)。观察组灌肠效果中评价为优的例数明显多于对照组(P<0.05)。结论小儿长段型先天性巨结肠术前洗肠的护理改进可以提升灌肠效果,缩短灌肠液用量以及灌肠时间所需时间等,值得广泛推广和临床应用。
Objective To investigate the improvement of nursing care for children with long-segment congenital megacolon before operation.Methods A total of 82 children with long-segment megacolon who were admitted and treated in our hospital from March 2015 to June 2018 were randomly divided into control group(n=41) and observation group(n=41).The patients in control group were treated by routine nursing and surgery according to standard medical procedures,however,the patients in observation group were treated by enema with an improved method of preoperative intestinal lavage and were treated according to the conventional surgical procedure.The average enema volume,intraoperative blood loss,postoperative intestinal peristalsis recovery time,and mean enema time were observed and compared between the two groups.Results The average enema volume and average enema time in observation group were superior to those in control group(P<0.05).The intraoperative blood loss and recovery time of postoperative bowel movement in observation group were better than those in control group,but the difference was not significant(P > 0.05).Moreover the operation time and hospitalization time in observation group were significantly better than those in control group(P<0.05),and the cases with good enema effects in observation group were significantly more than those in control group(P<0.05).Conclusion The improvement of nursing care for children with long-segment congenital megacolon can improve the enema effects,shorten the dosage of enema and the time required for enema,therefor,it is worthy of extensive promotion and clinical application.
Objective To investigate the improvement of nursing care for children with long-segment congenital megacolon before operation.Methods A total of 82 children with long-segment megacolon who were admitted and treated in our hospital from March 2015 to June 2018 were randomly divided into control group(n=41) and observation group(n=41).The patients in control group were treated by routine nursing and surgery according to standard medical procedures,however,the patients in observation group were treated by enema with an improved method of preoperative intestinal lavage and were treated according to the conventional surgical procedure.The average enema volume,intraoperative blood loss,postoperative intestinal peristalsis recovery time,and mean enema time were observed and compared between the two groups.Results The average enema volume and average enema time in observation group were superior to those in control group(P<0.05).The intraoperative blood loss and recovery time of postoperative bowel movement in observation group were better than those in control group,but the difference was not significant(P > 0.05).Moreover the operation time and hospitalization time in observation group were significantly better than those in control group(P<0.05),and the cases with good enema effects in observation group were significantly more than those in control group(P<0.05).Conclusion The improvement of nursing care for children with long-segment congenital megacolon can improve the enema effects,shorten the dosage of enema and the time required for enema,therefor,it is worthy of extensive promotion and clinical application.
引文
1陈芳芳,付晓君,姜磊,等.腹腔镜下改良Soave术Ⅰ期治疗小儿长段型先天性巨结肠疗效观察.中华全科医学,2017,15:1846-1848.
2 Tissingh EK,Memarzadeh A,Queally J,et al.Open lower limb fractures in Major Trauma Centers-A loss leader?Injury-international Journal of the Care of the Injured,2017,48:353-356.
3禚保彪,张宏伟,李圆,等.腹腔镜辅助Soave根治术治疗新生儿及2月内小婴儿长段型巨结肠疗效观察.中华胃肠外科杂志,2016,19:93-94.
4孙晓毅,余东海,李娜萍,等.先天性巨结肠同源病:临床诊断与手术指征的确立.中华小儿外科杂志,2010,31:839-843.
5张茜,汤绍涛,阳历,等.腹腔镜结合肛门外离断技术Duhamel手术治疗先天性巨结肠症的疗效观察.实用医院临床杂志,2016,13:31-34.
6赵海军,吴凯,王健俊,等.应用微阵列芯片技术分析先天性巨结肠微小RNAs表达谱差异.中华实用儿科临床杂志,2016,31:462-465.
7金惠明,吴晔明,陈杰.Currarino综合征合并先天性巨结肠病二例报道及文献复习.中华小儿外科杂志,2016,37:691-695.
8李玉峰,浦涧,吕昌恒,等.小儿先天性巨结肠腹腔镜辅助下改良Soave手术的临床治疗效果.结直肠肛门外科,2016,22:95-96.
9苏义林,徐兵,王忠荣.腹腔镜下巨结肠根治术治疗小儿先天性巨结肠的疗效.安徽医学,2017,38:304-306.
10 Shneider BL,Jean DV DG,Leung DH,et al.Primary prophylaxis of variceal bleeding in children and the role of meso rex bypass:summary of the baveno VI pediatric satellite symposium.Hepatology,2016,63:1368.
11王亮,王忠荣,徐兵,等.先天性巨结肠手术切缘Cajal间质细胞分布与术后便秘的关系.实用医学杂志,2016,32:157-158.
12黄振强,郑锦涛,李伟燎,等.改良心形吻合法在不同类型小儿先天性巨结肠中的应用.广东医学,2017,38:3831-3833.
13邱胜华,刘健,陈运平,等.循环型microRNA-92a在先天性巨结肠中的表达及上调2基因的研究.中国现代医学杂志,2016,26:19-24.
14王世平,段卫星.腹腔镜辅助下经肛门改良Soave术治疗常见型先天性巨结肠的疗效.中华实用儿科临床杂志,2017,32:316-317.
15 Naimo PS,Fricke TA,D’Udekem Y,et al.Surgical intervention for anomalous origin of left coronary artery from the pulmonary artery in children:a long-term follow-up.Annals of Thoracic Surgery,2016,101:1842-1848.
16董琦,王玉芸,孙为增,等.经脐倒“Ω”切口在婴幼儿先天性巨结肠结肠次全切除术中的应用.海南医学,2016,27:2704-2705.
17曹闯,吴江,黄庆荣.腹腔镜手术治疗先天性巨结肠的临床应用及安全性分析.中国现代普通外科进展,2017,20:368-370.
18滕银平,金先庆,李力,等.先天性巨结肠中HA117及SHH信号通路的表达及意义.中华小儿外科杂志,2016,37:253-257.
2 Tissingh EK,Memarzadeh A,Queally J,et al.Open lower limb fractures in Major Trauma Centers-A loss leader?Injury-international Journal of the Care of the Injured,2017,48:353-356.
3禚保彪,张宏伟,李圆,等.腹腔镜辅助Soave根治术治疗新生儿及2月内小婴儿长段型巨结肠疗效观察.中华胃肠外科杂志,2016,19:93-94.
4孙晓毅,余东海,李娜萍,等.先天性巨结肠同源病:临床诊断与手术指征的确立.中华小儿外科杂志,2010,31:839-843.
5张茜,汤绍涛,阳历,等.腹腔镜结合肛门外离断技术Duhamel手术治疗先天性巨结肠症的疗效观察.实用医院临床杂志,2016,13:31-34.
6赵海军,吴凯,王健俊,等.应用微阵列芯片技术分析先天性巨结肠微小RNAs表达谱差异.中华实用儿科临床杂志,2016,31:462-465.
7金惠明,吴晔明,陈杰.Currarino综合征合并先天性巨结肠病二例报道及文献复习.中华小儿外科杂志,2016,37:691-695.
8李玉峰,浦涧,吕昌恒,等.小儿先天性巨结肠腹腔镜辅助下改良Soave手术的临床治疗效果.结直肠肛门外科,2016,22:95-96.
9苏义林,徐兵,王忠荣.腹腔镜下巨结肠根治术治疗小儿先天性巨结肠的疗效.安徽医学,2017,38:304-306.
10 Shneider BL,Jean DV DG,Leung DH,et al.Primary prophylaxis of variceal bleeding in children and the role of meso rex bypass:summary of the baveno VI pediatric satellite symposium.Hepatology,2016,63:1368.
11王亮,王忠荣,徐兵,等.先天性巨结肠手术切缘Cajal间质细胞分布与术后便秘的关系.实用医学杂志,2016,32:157-158.
12黄振强,郑锦涛,李伟燎,等.改良心形吻合法在不同类型小儿先天性巨结肠中的应用.广东医学,2017,38:3831-3833.
13邱胜华,刘健,陈运平,等.循环型microRNA-92a在先天性巨结肠中的表达及上调2基因的研究.中国现代医学杂志,2016,26:19-24.
14王世平,段卫星.腹腔镜辅助下经肛门改良Soave术治疗常见型先天性巨结肠的疗效.中华实用儿科临床杂志,2017,32:316-317.
15 Naimo PS,Fricke TA,D’Udekem Y,et al.Surgical intervention for anomalous origin of left coronary artery from the pulmonary artery in children:a long-term follow-up.Annals of Thoracic Surgery,2016,101:1842-1848.
16董琦,王玉芸,孙为增,等.经脐倒“Ω”切口在婴幼儿先天性巨结肠结肠次全切除术中的应用.海南医学,2016,27:2704-2705.
17曹闯,吴江,黄庆荣.腹腔镜手术治疗先天性巨结肠的临床应用及安全性分析.中国现代普通外科进展,2017,20:368-370.
18滕银平,金先庆,李力,等.先天性巨结肠中HA117及SHH信号通路的表达及意义.中华小儿外科杂志,2016,37:253-257.