陈旧性会阴Ⅲ-Ⅳ度撕裂伤患者行直肠阴道隔修补术及会阴重建术围手术期护理

Perioperative nursing of patients with old perinealⅢ-Ⅳdegree lacerations undergoing rectal vaginal septal repair and perineal reconstruction

目的总结陈旧性会阴Ⅲ-Ⅳ度撕裂伤患者行直肠阴道隔修补术及会阴重建术围手术期护理要点,为临床护理措施的制定和改进提供借鉴。方法给予2017年2月至2020年1月在我院接受直肠阴道隔修补术及会阴重建术的81例陈旧性会阴Ⅲ-Ⅳ度撕裂伤患者实施包括心理护理、健康宣教、术前准备、切口感染预防护理、肛管及排便护理、并发症预防护理等围手术期系统化护理。结果所有患者均顺利完成手术,术后4例出现切口感染,经抗感染治疗后切口愈合,无其他严重术后并发症发生;术后3个月随访,所有患者直肠及阴道形态和功能正常,患者对修补手术效果满意,护理满意度100%。结论陈旧性会阴Ⅲ-Ⅳ度撕裂伤是严重影响肛门及阴道形态和功能的损伤,直肠阴道隔修补术及会阴重建术可有效修复患者受损肛门及阴道,根据围手术期病情及患者需要,开展系统化围手术期护理措施,可有效提升修复效果,促进伤口愈合,提升患者术后生活质量和护理满意度。

Objective To summarize the perioperative nursing points of patients with old perinealⅢ-Ⅳdegree lacerations for rectal vaginal septal repair and perineal reconstruction to provide reference for the formulation and improvement of clinical nursing measures.Methods 81 cases of old perinealⅢ-Ⅳdegree lacerations undergoing rectal vaginal septal repair and perineal reconstruction in our hospital from February 2017 to January 2020 were performed including psychological care,health education,preoperative preparation,incision Perioperative systemic nursing such as infection prevention nursing,anal canal and defecation nursing,and complications prevention nursing.Results All patients successfully completed the operation,and 4 patients had incision infection after operation.The incision healed after anti-infection treatment,and no other serious postoperative complications occurred;3 months after surgery,all patients had normal rectal and vaginal morphology and function Satisfied with the effect of repair surgery,nursing satisfaction is 100%.Conclusion Old perinealⅢ-Ⅳdegree laceration is a serious injury to the shape and function of the anus and vagina.Rectal vaginal septal repair and perineal reconstruction can effectively repair the damaged anus and vagina of the patient.According to the perioperative condition and patient needs,Carrying out systematic perioperative nursing measures can effectively improve the repair effect,promote wound healing,and improve the patient's postoperative quality of life and nursing satisfaction.