胸腔镜下行Heller手术治疗贲门失迟缓症的围手术期护理

Perioperative nursing of patients with achalasia of cardia treated with cardiomyotomy by VATS

目的探讨胸腔镜下行贲门肌层切开术(Heller手术)治疗贲门失迟缓症的围手术期护理体会。方法回顾性分析2010年1月～2011年4月本科室20例贲门失迟缓症患者在胸腔镜下行Heller手术治疗的临床资料,并总结围手术期的护理要点。结果 20例患者术程顺利,手术时间45～65min,平均(53.75±4.88)min;术中出血量20～30mL,平均(24.90±3.40)mL。经对症治疗和护理后,患者痊愈出院,无1例出现并发症;随访3～18个月,患者无复发。结论术前重视消化道准备及呼吸功能训练,术后严密观察病情变化,加强引流管护理,预防并发症,其是胸腔镜下行Heller手术治疗贲门失迟缓症取得成功的关键措施。

Objective To summarize the experience in nursing the patients with achalasia of cardia treated with cardiomyotomy by VATS. Method Retrospective analysis on the clinical data of 20 achalasia of cardia patients during January 2010 and April 2011 were conducted to summarize the main points of perioperative nursing. Results The operations for all the 20 patients were smooth, the operation during 45 ～ 65 min, averaged （53.75 ± 4.88）min, and intraoperative blood loss 20 ～ 30 mL, averaged （24.90 ± 3.40）mL. All the patients had recovered and discharged without any complications. No recurrence occurred during follow-up 3 ～ 18 moths. Conclusion Active preparation for alimentary canal and exercise of respiratory function before operation, careful observations over the patients, enhanced nursing of drainage tube and active prevention of complications after operation, are critical for the success of cardiomyotomy by VATS in the treatment of achalasia of cardia.