婴幼儿先天性胆总管囊肿自发性穿孔的护理体会

目的：探讨先天性胆总管囊肿自发性穿孔的护理经验。方法：回顾性分析11例婴幼儿先天性胆总管囊肿自发性穿孔患儿自发性穿孔的临床资料。结果：本组8例经术前腹腔穿刺确诊胆道自发性穿孔，其中5例经B超或CT诊断胆总管囊肿。3例行一期胆总管囊肿切除加胆道重建术（胆总管-空肠R—Y吻合术）；6例行胆道外引流加腹腔引流术，2例行胆囊置管引流加腹腔引流术，3～6个月后行胆总管囊肿切除加胆道重建术。11例患儿治疗后均恢复良好。结论：婴幼儿胆总管囊肿自发性穿孔容易误诊，掌握其临床特点、根据患儿具体情况选择合理的手术方式以及精心细致的护理是提高其治愈率的关键。

Nursing for spontaneous perforation of choledochal cyst in infant

Objective： To .investigate the nursing experience for spontaneous perforation of congenital choledochal cyst in infants. Methods： The clinical data of t 1 cases with spontaneous perforation of congenital choledochal cyst were analysed retrospectively. Results： The preoperative diagnosis was established by paracentesis in 8 patients. Abdominal sonography and CT found a cyst in 5 of the 8 cases reviewed. 3 different operative procedures were performed, choledochocyst excision ＆ Roux-Y choledocho-jejunostomy（3 cases）, choledochotomy with T-tube drainage （6 cases）,and cholecystostomy（2 cases） . Radical resection was performed in about 3-6 months after the initial operation. All patients recovered had got satisfactory therapeutic efficacy without any grave complication. Conclusion： The misdiagnosis of spontaneous perforation of congenital choledochal cyst in infants is more common,with understanding keys in the diagnosis and correct operation and meticulous care are important in improving the cure rate.