腹腔镜Kasai手术治疗先天性胆道闭锁患儿的护理研究

摘要/Abstract

摘要： 目的探讨腹腔镜肝门空肠吻合术（Kasai手术）治疗先天性胆道闭锁患儿的护理方法及效果。方法选取2018年1月~2021年6月乌鲁木齐市第一人民医院收治的116例先天性胆道闭锁患儿作为研究对象,采用随机数表法分为对照组和观察组,每组58例。对照组实施常规护理干预,观察组实施康复护理干预。对比两组患儿的护理效果、并发症（感染、胆管炎、腹腔积液、肝衰竭）发生率。结果观察组并发症发生率小于对照组,差异有统计学意义（P<0.05）。观察组进饮进食时间、胃管拔除时间、肛门排气时间、肛门排便时间、肠鸣音恢复时间、住院时间均短于对照组,差异有统计学意义（P<0.05）。结论腹腔镜Kasai术治疗先天性胆道闭锁患儿期间,联合实施康复护理干预,可进一步提升患儿的护理效果,有效降低患儿的并发症发生率,缩短术后康复时间和平均住院时间,值得临床应用。

关键词: 腹腔镜Kasai手术, 先天性胆道闭锁, 常规护理干预, 康复护理干预

Abstract: Objective To investigate the nursing methods and effects of laparoscopic hepaticojejunostomy (Kasai procedure) for children with congenital biliary atresia. Methods 116 children with congenital biliary atresia admitted to the First People's Hospital of Urumqi from January 2018 to June 2021 were selected as study subjects. They were divided into the control and the observation groups using a random number table, with 58 cases in each group. The control group was given conventional nursing intervention and the observation group was given rehabilitation nursing intervention. The nursing effects and the incidence of complications (infection, cholangitis, peritoneal effusion and liver failure) were compared between the two groups. Results The incidence of complications in the observation group was lower than that in the control group, the difference has statistically significant (P<0.05). Time of drinking and eating, gastric tube removal, anal venting, anal defecation, recovery of bowel sounds and hospital stay was shorter in the observation group than that in the control group, the difference has statistically significant (P<0.05). Conclusion The combined implementation of rehabilitation nursing intervention during laparoscopic Kasai operation for children with congenital biliary atresia can further improve the nursing effect, effectively reduce the complication rate, and shorten the postoperative recovery time and average hospital stay in affected children. This method is worthy of clinical application.

Key words: Laparoscopic Kasai operation, open Kasai procedure, congenital biliary atresia, conventional nursing intervention, rehabilitation nursing intervention

中图分类号:

R473.72

何静. 腹腔镜Kasai手术治疗先天性胆道闭锁患儿的护理研究[J]. 中华养生保健, 2022, 40(9): 1-3.

HE Jing. Study on the Nursing of Children with Congenital Biliary Atresia Treated with Laparoscopic Kasai Operation[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(9): 1-3.

参考文献

[1] 邹沙芹,段伟莉,周桂芬,等.PBL式营养指导在胆道闭锁护理中的应用研究[J].当代护士(上旬刊),2021,28(4):109-111.
[2] Davenport M, Muntean A, Hadzic N.Biliary Atresia: Clinical Phenotypes and Aetiological Heterogeneity[J]. Journal of Clinical Medicine, 2021, 10(23): 5675-5685.
[3] Wang R, Fang S, Sun Q, et al.Congenital biliary atresia in an infant born to hepatitis B mother treated with telbivudine before and during pregnancy[J]. Digestive and liver disease, 2018, 50(10): 1097-1098.
[4] 李玲,杨巧玲,陈代祯,等.快速康复联合延续性护理模式在胆道闭锁患儿术后的应用[J].国际护理学杂志,2020,39(21):3839-3843.
[5] 中华医学会小儿外科学分会肝胆外科学组,中国医师协会器官移植医师分会儿童器官移植学组.胆道闭锁诊断及治疗指南(2018版)[J].临床肝胆病杂志,2019,35(11):2435-2440.
[6] 宋莉萍,刘利爱,周茉.延续性护理预防先天性胆道闭锁术后胆道感染的效果分析[J].当代护士(中旬刊),2019,26(6):64-65.
[7] 农淑珍. 延续性护理在预防接受手术治疗的先天性胆道闭锁患儿术后发生胆管炎中的应用效果[J].当代医药论丛,2018,16(21):227-228.
[8] 李玲,杨巧玲,王茂林,等.加速康复外科在胆道闭锁患儿腹腔镜手术护理中的应用[J].国际护理学杂志,2020,39(4):690-692.
[9] 刘莹,于颖,崔亚娟,等.1例先天性胆道闭锁术后患婴行活体肝移植术后并发胃瘫的护理[J].现代临床护理,2019,18(1):82-85.
[10] Negm Ahmed A,Manns Michael P,Markowski Andrea,et al.The Role of Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Biliary Atresia: 14 Years' Experience[J].European journal of pediatric surgery,2018,28(3):261-267.
[11] 杨勤玲,肖奇贵.胆道闭锁患儿肝移植术后并发症的观察及护理[J].护理学报,2021,28(18): 50-52.
[12] 申晓敏. 1例先天性胆道闭锁患儿行亲体肝移植术后并发症的护理[J]. 全科护理,2020,18(15):1917-1918.
[13] 郑珊. 胆道闭锁患儿获得长期生存需要关注的问题[J]. 临床小儿外科杂志,2020,19(6):469-472.
[14] 任平,张玉侠,顾莺,等.胆道闭锁术后患儿延续性护理的效果评价[J].护理学杂志,2015,30(18):88-90.
[15] 杨雅慧,赵欢欢,卢亚芳.延续性护理预防先天性胆道闭锁术后患儿晚期胆管炎的效果观察[J]. 智慧健康,2020,6(6):68-69.