儿童疝囊高位结扎术的术后护理及并发症预防

Postoperative nursing and complication prevention for high ligation of hernia sac in children

目的探讨经脐单孔联合硬膜外穿刺针输尿管镜下疝囊高位结扎术治疗儿童腹股沟斜疝的术后护理及并发症预防经验。方法回顾性分析2012年5月至2014年12月,滦县人民医院应用经脐单孔联合硬膜外穿刺针输尿管镜下疝囊高位结扎术治疗儿童腹股沟斜疝206例患儿的手术及术后护理、随访资料,患儿年龄6个月至13岁,平均5岁。结果手术过程均顺利,手术时间5~20 min,切口无需缝合。术中发现对侧鞘状突未闭13例（6.3%）。术后1~2 d出院。随访患儿症状消失,术后腹部无明显瘢痕,无复发。结论经脐单孔联合硬膜外穿刺针输尿管镜下疝囊高位结扎术治疗儿童腹股沟斜疝,经术中规范操作及术后专业护理,治疗效果良好,未出现严重并发症,值得临床借鉴与推广。

Objective To review the postoperative nursing and complication prevention experience of trans-umbilical single port combined epidural puncture needle ureteroscopic high ligation of hernia sac in children. Methods From May 2012 to December 2014,a total of 206 children（ age of 6 months to13 years,mean of 5 years） with indirect inguinal who underwent trans-umbilical single port combined epidural puncture needle ureteroscopic high ligation of hernia sac in Luanxian people＇ s hospital were retrospectively analyzed. The operation details,postoperative nursing,follow-up data were recorded. Results All operations were completed successfully,with the operating time ranged 5 to 20 minutes,and no wound suture was needed. There were 13 cases（ 6. 3%） of children that were found with unclosed contralateral vaginal process. All children were discharged in 1 to 2 days,and there were obvious abdominal scars or recurrence in the follow-up. Conclusion The trans-umbilical single port combined epidural puncture needle ureteroscopic high ligation of hernia sac for indirect inguinal hernia in children is safe and effective,when the standard procedures and postoperative nursing are applied. It is worthy of clinical promotion.