6例高位小肠坏死早产儿Bishop-Koop肠造口术后护理

目的 总结6例高位小肠坏死早产儿采用Bishop-Koop肠造口术的护理经验。方法 对诊断小肠坏死的早产儿行剖腹探查术,术中发现高位小肠坏死者采用Bishop-Koop肠造口术式,术后护理人员严密观察腹部体征;保持引流管及减压管通畅;保持患儿内环境稳定;加强输液管理;积极喂养;促进恢复。结果 本组6例患儿,2例提前行Ⅱ期造口还纳术,3例恢复良好封堵造口出院,择期行造口还纳术,1例放弃治疗后死亡。结论 高位小肠坏死患儿救治难度大,Bishop-Koop肠造口术可尽量保留患儿较多肠管,术后加强精细化护理及并发症观察,可提高患儿生存率。

Nursing of Premature Babies with High Location Enteric Necrosis Undergoing Bishop-koop Stoma Procedure: A 6-case Study

Objective To summarize the nursing experience of 6 premature babies with high location enteric necrosis undergoing Bishop-koop stoma procedure (BP). Methods Exploratory laparotomy was performed in premature babies with enteric necrosis and intraoperative BP was conducted for those with high location enteric necrosis. Abdominal signs were observed closely after the surgery. Management of drainage tube and decompression tube, the stability of the internal environment, transfusion management and active feeding were critical in postoperative nursing. Results Stoma apotheosis surgery was performed ahead of time for 2 cases; 3 cases recovered, having selective stoma apotheosis surgery and 1 case died after treatment abandonment. Conclusion It is tricky to deal with premature babies with enteric necrosis. For those undergoing BP, longer bowel, postoperative careful nursing and close observation of complications are conducive to the survival.