腹腔镜治疗先天性肥厚性幽门狭窄手术并发症的原因分析及护理对策

Analysis of the causes and nursing countermeasures of complications after the laparoscopy- assistedsurgery for congenital hypertrophic pyloric stenosis

目的总结腹腔镜治疗先天性肥厚性幽门狭窄手术并发症的相关因素及护理对策。方法对我院106例行腹腔镜幽门环肌切开术的新生儿及小婴儿手术并发症发生情况及护理要点进行回顾性分析。结果发生手术并发症16例，其中黏膜穿孔2例，腹腔内出血1例，穿刺孔感染1例，幽门分离不全致术后反复呕吐1例，高碳酸血症2例，皮下气肿1例，低体温8例。无手术死亡病例，无戳孔疝及腹腔内脏器损伤。经细致观察及精心护理，并发症明显改善，术后3。7d均痊愈出院，无一例发生护理并发症。结论并发症的早期发现和及时护理干预是腹腔镜治疗先天性肥厚性幽门狭窄手术患儿顺利康复出院的重要保障。

Objective To summarize the related factors and nursing countermeasures of complica- tions after the laparoscopy-assisted surgery for congenital hypertrophic pyloric stenosis. Methods Clini- cal data about the occurrence of complications and nursing points were retrospectively analyzed in 106 cas- es of neonates and infants. Results Surgical complications occurred in 16 cases, including mucosal per- foration in 2 cases, abdominal cavity hemorrhage in 1 case, puncture hole infection in 1 case, repeated postoperative vomiting caused by incomplete pyloric separation in 1 case, postoperative hypercapnia in 2 cases, subcutaneous emphysema in 1 case, 8 cases of postoperative hypothermia. No operative deaths. No poking holes hernia and abdominal organ injury. By careful observation and nursing, all cases got rid of post- operative complications. Within postoperative 3~7 days, they were recovered and discharged, no nursing com- plications occurred. Conclusions Early discovery of complications and timely nursing intervention are impor- tant guarantee for patients to pass through laparoscopic surgery smoothly and obtain swift recovery.