摘要
总结7例腐蚀性食管狭窄患儿行结肠移植代食管术后并发症的观察及护理经验。护理要点:成立跨学科团队,根据术后并发症特点,针对性地进行治疗和护理;重视术后反流、误吸的评估及干预;吞咽困难的早期识别及康复护理;肺部感染的预防和护理及早期呼吸功能训练;颈部吻合口狭窄的评估及预防和造瘘口维护;个体化的健康宣教及随访。7例患儿术后两周内有4例出现反流,1例出现误吸,1例出现吞咽困难,5例出现肺部感染;术后随访2月内有2例出现胃/空肠造瘘口周围皮肤感染;术后随访1年内有2例颈部吻合口狭窄。经过精心治疗、护理和随访,7例患儿结肠代食管术术后食管功能恢复良好,术后(5.83±1.94)d停止肠外营养,逐步恢复经口进食,术后(42.66±8.16)d关闭胃/空肠造瘘。2例颈部吻合口狭窄的患儿行食管扩张术,术后恢复良好。
To summarize the observation and nursing care of postoperative complication in 7 children with corrosive esophageal stenosis undergoing colon transplantation for esophageal replacement surgery.The nursing points included:Establishing an interdisciplinary collaborative team to provide targeted treatment and care based on the different characteristics of postoperative complications;Paying attention to assessment and intervention of postoperative reflux and aspiration;Early identification and rehabilitation care for dysphagia;Ilmplementation and nursing of pulmonary infection and early respiratory function training;Assessment and prevention of cervical anastomotic stenosis and maintenance of the stoma;Personalized health education and follow up.Within two weeks after surgery,4 of the 7 patients experienced reflux,1 had aspiration,1 had dysphagia,and 5 had pulmonary infections.Within 2 months of postoperative follow-up,there were 2 cases of skin infection around the stoma of the gastric/jejunostomy.There were 2 cases of cervical anastomotic stenosis within one year of postoperative fllow-up.After meticulous treatment,care,and follow-up,the esophageal function of 7 children with colon replacement esophagectomy recovered well.After(5.83±1.95)days of surgery,parenteral nutrition was stopped and oral feeding gradually resumed.After(43.00±7.51)days of surgery,gastric/jejunostomy was closed.Two children with cervical anastomotic stenosis underwent esophageal dilation surgery,and the postoperative recovery was good.
作者
朱嘉英
顾莺
杨玉霞
贺骏
沈伟杰
柳宇鑫
胡静
ZHU Jiaying;GU Ying;YANG Yuxia;HE Jun;SHEN Weijie;LIU Yuxin;HU Jing
出处
《中华急危重症护理杂志》
CSCD
2024年第4期319-322,共4页
Chinese Journal of Emergency and Critical Care Nursing
基金
2022年度市级医院诊疗技术推广及优化管理项目/原临床科技创新项目(SHDC22022221)
2021年上海市医苑新星青年医学人才培养资助计划(沪卫人事[2022]65号)。
关键词
结肠
食管狭窄
移植
手术后并发症
危重病护理
Colon
Esophageal Stenosis
TransplantationP
ostoperative Complications
Critical Care Nursing
