新生儿胎盘循环下行膈疝修补及肺囊腺瘤切除术的护理

The nursing of a newborn underwent diaphragmatic hernia repair and pulmonary cystadenoma resection under complete placental circulation support

报告1例双绒毛膜双羊膜囊双胎妊娠剖宫产术中为1胎患儿行完全胎盘循环支持下的膈疝修补及肺囊腺瘤切除术的护理体会。护理要点:术前多学科联合模拟演练,术中使用自制宫腔灌流系统实现精准宫腔控压以维持胎盘循环,可视化技术助力双胎新生儿抢救,个性化母胎监护及精细化管理保障手术安全。手术用时78 min,新生儿A(膈疝儿)出生1 min、5 min、10 min Appar评分为3分、4分、8分,NICU治疗及护理13 d后出院;新生儿B(健康儿)出生1 min、5 min、10 min Apgar评分为2分、5分、8分,普通监护室护理6 d后出院;产妇剖宫产术后6 d出院。随访4个月,产妇、新生儿情况稳定,无并发症发生。

One of double-chorionic double-amniotic sac twin pregnancy was underwent diaphragmatic hernia repair and pulmonary cystadenoma resection during cesarean section in the condition of complete placental circulation.The nursing key points were summarized as follow:preoperative multidisciplinary joint simulation exercises,placental circulation maintaining under precise uterine cavity pressure control using a self-made intrauterine perfusion system,newborn resuscitation with visualized technology assistance,operational safety assurance with personalized maternal-fetal monitoring and refined management.The operational time was 78 minutes.Newborn with congenital diaphragmatic hernia was born with Apgar score of 3-4-8 at 1-5-10 minute.The newborn with diaphragmatic hernia was discharged after 13 days of treatment and nursing in NICU.The healthy newborn’s Apgar score was 2-5-8 at1-5-10 minute after birth.The healthy newborn was discharged after 6 days of general care.The parturient was discharged 6 days after the cesarean section.After 4 months of follow-up,the parturient and newborn babies were all in good condition and had no complications.