低位直肠癌患者经结肠肛管吻合术的护理

目的总结低位直肠癌患者经结肠肛管吻合术(Parks术)的护理要点。方法给予56例低位直肠癌患者行Parks术,术前给予患者进行肠道准备、心理护理及营养饮食的护理;术后做好吻合口漏及吻合口狭窄的护理,并加强肛门功能锻炼。结果所有患者手术过程顺利,肿瘤均获根治性切除;各有1例吻合口出血和吻合口漏,分别经结肠造口和保守治疗而痊愈;9例患者发生吻合口轻度狭窄,经过扩肛处理后均有好转;2例肛门扩约肌功能不良,肛门括约肌功能优良率为92.2%。结论术前护士应对患者进行心理疏导,增强患者治疗的信心;术后加强吻合口的观察护理,指导患者进行肛门功能的锻炼,可减少术后并发症,促进患者早日康复。

Objective To summarize main points in caring lower rectal cancer patients with the anastomosis of colon and anus （Parks＇）. Methods 56 lower rectal cancer patients underwent the anastomosis of colon and anus （Park＇s）. The nursing methods included preoperative colonic preparation, mental care and nutritious diets, postoperative care of rectal bleeding, anastomotic leakage, and anastomotic stenosis as well as enhanced exercises on anal function. Results The whole process was successful for all the cases. Other complications included 1 case of anastomotic bleeding, 1 case of anastomotic leakage, which was cured by colonic stoma and conservative treatment. Slight stegnosis in 9 patients was relieved by anal expansion. 2 cases suffered from temporarily impaired function of the anal sphincter. The excellence rate of anal sphincter reached 92.2%. Conclusions The nurses should implement mental care for patients to consolidate their confidence in treatment. Postoperative close observation should be enhanced and the patients should be instructed in terms of exercises of anal function, which will help reduce complications and promote their recovery.