手助腹腔镜全结肠切除术回肠储袋治疗家族性腺瘤性息肉病患者的术后并发症及护理

The postoperative complications and nursing experience of hand assisted laparoscopic J-type ileal pouch-anal anastomosis in familial adenomatous polyposis

目的：总结家族性腺瘤性息肉病（FAP）患者行手助腹腔镜下全结肠切除J型回肠储袋-肛管吻合术（IPAA）术后并发症及其护理体会。方法对我科36例行IPAA的FAP患者进行回顾性分析。结果2例于术后出现回肠储袋出血，3例女性患者术后出现尿潴留，3例术后外痔水肿明显，2例出现吻合口瘘，经过相关治疗及护理，均好转出院，在术后随访中有6例出现储袋炎，经过积极治疗后好转。结论 FAP患者行IPAA，手术难度大，容易出现并发症，护理难度大，加强围手术期护理，可减少并发症的发生，提高患者的生命质量。

Objective To investigate the postoperative complication and nursing experience of hand-assisted laparoscopic J-type ileal pouch-anal anastomosis (IPAA) in familial adenomatous polyposis (FAP). Methods A total of 36 patients with FAP who had undergone hand-assisted laparoscopic J-type ileal pouch- anal anastomosis (IPAA) were analyzed retrospectively. Results The postoperative complication included ileal pouch bleeding in 2 cases, urinary retention in 3 female patients, external hemorrhoids swelling in 3 cases, and anastomotic fistula in 2 cases. Six cases had ileum pouch inflammation during the postoperative follow- up. All the complications were relieved after conservative medical therapy. Conclusions IPAA operation puts forward high technical requirements with more postoperative complications. Therefore, it is important to strengthen nursing of the patients, reduce postoperative complication and increase quality of life of FAP.