经脐单孔腹腔镜下小儿巨结肠根治术的手术室护理体会

Nursingin in operating room of children undergoing transumbillcal laparoendoscopic single site surgery for Hirschsprung's disease

目的 探讨小儿经脐单孔腹腔镜巨结肠根治术的手术室护理措施。方法 选择2020年3月至2022年10月我院小儿外科收治的先天性巨结肠患儿96例,根据手术方式不同分为常规腹腔镜手术组(CLS组)46例,在常规围术期综合护理上采用传统宣教方法;经脐单孔腹腔镜手术组(TU-LESS组)50例,在常规围术期综合护理上采用多维度宣教方法。比较两组手术指标(包括手术时间、术中出血量、患儿家属对切口美容效果的满意度)及护理指标(包括术中低体温及压力性损伤的发生率、术前宣教效果满意度)。结果 两组的手术时间、术中出血量、术中低体温发生率及压力性损伤发生率比较,差异无统计学意义(P>0.05);TU-LESS组的患儿家属对手术切口美容效果的满意度及术前宣教满意度均高于CLS组,差异均有统计学意义(均P<0.05)。结论 在先天性巨结肠根治术中,TU-LESS比CLS具有更好的美容效果,患儿家属的满意度更高。

Objective To explore the operating room nursing measures for laparoscopic radical surgery of pediatric Hirschsprung's disease via the single umbilical incision.Methods 96 children with congenital Hirschsprung's disease admitted to our pediatric surgery department from March 2020 to October 2022 were selected.Different surgical methods divided them into a conventional laparoscopic surgery group(CLS)of 46 cases and transumbilical laparoendoscopic single-site surgery(TU-LESS)of 50 cases.Traditional education methods were implemented in the CLS group's comprehensive care during the perioperative period,while multidimensional education methods were implemented in the TU-LESS group.Surgical indicators(including operation time,intraoperative blood loss,and satisfaction of the surgical incision's cosmetic effect by the patient's family)and nursing indicators(including the incidence of intraoperative hypothermia,incidence of pressure injuries,and satisfaction of preoperative education)were compared between the two groups.Results There was no significant difference in the operation time,intraoperative blood loss,the incidence of intraoperative hypothermia,and the incidence of pressure injuries between the two groups(P>0.05).The satisfaction with the surgical incision's cosmetic effect and preoperative education in the TU-LESS group were significantly higher than those in the CLS group,and the differences were statistically significant(P<0.05).Conclusion TU-LESS has better cosmetic effects and higher satisfaction of the patient's family in the radical surgery of congenital Hirschsprung's disease compared to CLS.