食管癌、贲门癌术后膈疝的观察与护理

目的:探讨食管癌、贲门癌术后膈疝的观察与护理。方法:我科2008年1月～2009年6月发生食管癌、贲门癌术后膈疝8例,其中食管中段癌5例,贲门癌3例。膈疝发生最早时间为术后第3d,最晚发生在术后20年。结果:7例患者经胸片和CT明确诊断膈疝,1例因疑诊为肠梗阻,术中发现膈疝,均行膈疝修补术,术后恢复顺利,均痊愈出院。结论:食管癌、贲门癌术后膈疝是一种少见的并发症,手术前后呼吸道及消化道的管理、有效的生活护理、心理疏导有利于预防术后膈疝的发生,细致的临床观察有助于术后膈疝的发现和及时治疗。

The observation and nursing of diaphragmatic hernia after the operation of esophageal cancer and cardiac cancer

Objective：To investigate the perioperative nursing for diaphragmatic hernia after esophagectomy for cancer. Methods： Eight patients who underwent esophagectomy for cancer had postopretive diaphragmatic hernia from Jan.2008 to Jun.2009 in the department of thoracic surgery,five patients with esophageal carcinoma underwent esophagectomys.3 patients with cardiac carcinoma.The occurring time of diaphragmatic hernia after esophagectomy for cancer ranged from postoperative 3th day to 20th year.Results：The diaphragmatic hernia were diagnosised definitely in seven patients with esophagectomy for cancer by X-ray and CT,including that occurring of intestinal obstruction was doubted in 1 patient but diaphragmatic hernia was in operation. All of patients underwent surgery for repair of diaphragmatic hernia. They recovered well after the surgery and were cured to leave hospital.Conclusion：Diaphragmatic hernia is a rare complication after surgery of esophageal and cardiac cancer. It is helpful to prevent occurring of postoperative diaphragmatic hernia that the patients with esophagectomy for cancer are provided with careful nursing for respiratory and alimentary tract,effective nursing of life as well as psychological help. The careful clinical nursing for patients with esophagectomy for cancer contributes to diagnosis and treatment for postoperative diaphragmatic hernia in time.