1例新生儿幽门闭锁合并大疱表皮松解症的护理

Nursing care of a neonate with congenital pyloric atresia and epidermolysis bullosa

报告1例先天性幽门闭锁合并大疱表皮松解症新生儿的护理。在做好术前全身营养支持的基础上,严格执行无菌操作,积极处理新发水疱与创面,采用"十字对穿"法使疱液自然流出,使用温生理盐水局部脉冲冲洗技术清洁创面,避免二次损伤,同时可减轻换药的疼痛;根据湿性愈合原则,采用软聚硅酮泡沫敷料处理水疱和创面。术中经腹放置空肠营养管,早期开展微量肠内营养,待胃肠功能完全恢复后逐渐过渡到口服喂养,热量不足部分由静脉补充。治疗期间未出现肠穿孔、肠扭转、堵管等置管并发症,未发生粘连性肠梗阻及胆汁淤积,无呕吐、腹胀、腹泻。经过31 d的精心护理,患儿好转出院。

This paper reported nursing care of a neonate with congenital pyloric atresia and epidermolysis bullosa. On the basis of general preoperative support and strict aseptic operation, we actively dealt with new blister and wounds. Warm saline local pulse flushing method was used to avoid the secondary damage and relieve the pain during dressing change. According to wet healing principles, soft silicone foam dressings were applied on blisters and wounds. The infant was intraoperatively placed with nasal intestinal feeding tube and received postoperative early enteral nutrition and underwent oral feeding after the recovery of gastrointestinal function. There were no catheter-related complications such as intestinal perforation, intestinal volvulus, plugging, and no adhesiveileus, vomiting or cholestasis occurred. After 31 day careful nursing, the infant was recovered and discharged from hospital.