先天愚型患儿行先天性巨结肠根治术的护理进展

Nursing progress of the radical operation of Hirschsprung's disease for children with Down's syndrome

先天性巨结肠是一种常见的肠神经发育障碍性疾病,其在新生儿中的发病率大约为1/5000,患儿通常需要进行巨结肠根治术进行治疗。部分先天性巨结肠患儿也可伴有唐氏综合征,此类患儿通常临床表现较重且常伴发其他系统的功能障碍,因此他们在进行先天性巨结肠根治术后的并发症发生率较高,并且远期肠道功能恢复情况较不理想,给患儿本身及整个家庭带来沉重的经济和心理负担,目前对此类患儿进行针对性治疗是当前研究与临床实践的重点及难点。高质量的围手术期护理干预对确保患儿手术顺利和术后康复意义重大,但目前尚缺乏针对此类患儿的护理指南。本文对伴有唐氏综合征的先天性巨结肠患儿的围术期护理管理做一综述,内容主要涉及术前准备、术后基本护理、饮食指导、并发症预防、肛门扩张及远期康复指导、人文关怀和心理支持,为提高这类患儿的临床护理质量提供参考依据。

Hirschsprung's disease is a common disorder of the enteroneurodevelopmental disease,and occurs in approximately 1 out of every 5000 live births,which usually requires radical megacolon surgery for treatment.Children with Hirschsprung's disease may also have Down's syndrome who have severe clinical manifestations and are often accompanied by dysfunction of other systems,so they will suffer from a higher incidence of postoperative complications and poor recovery of long-term intestinal function,which can bring heavy economic and psychological burden to the children and the entire family,and targeted treatments of these children are the focus and difficulty of current researches and clinical practices.The high-quality perioperative nursing intervention is a key issue to improve the success of operation and postoperative rehabilitation,but there is still no nursing guide for such patients.This article reviews the perioperative nursing management of children with both Hirschsprung's disease and Down's syndrome,and the content mainly involves preoperative preparation,postoperative basic care,dietary guidance,prevention of complications,anal dilation and long-term rehabilitation guidance,humanistic care and psychological support,which provides a reference for improving the quality of clinical care.