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家族性甲状腺髓样癌高危儿童甲状腺预防性切除术围手术期护理一例

内镜黏膜下剥离术治疗胃肠道间质瘤的围手术期护理

目的　总结内镜黏膜下剥离术（ESD）治疗胃肠道间质瘤的围手术期护理方法。 方法　回顾分析2007年1月－2011年8月符合内镜下治疗77例胃肠道间质瘤患者行ESD的临床资料和护理措施。 结果　77例患者全部经内镜完整切除肿瘤，其中3例出现出血，5例发生穿孔，2例发生术后狭窄，经内科保守治疗、内镜下治疗以及围手术期精心护理，患者痊愈出院。 结论　ESD治疗胃肠道间质瘤安全、有效，正确细致的各项护理措施是胃间质瘤患者手术获得成功、且身体早日康复的有力保障。

主动脉窦动脉瘤破裂合并妊娠前置胎盘的围手术期护理一例

The Perioperative Period Nursing and Functional Exercise of the Deltoid Contracture

目的:总结28例三角肌挛缩症的护理和功能训练方法。方法:回顾性分析1992~2008年我科共收治的三角肌挛缩症患儿28例的临床护理资料。结果:经6个月至14年的随访,结果显示除1例遗留轻度翼状肩胛外,其余病例肩关节的外展畸形消失,肩关节活动功能恢复正常,X线照片复查显示肩关节关系恢复正常。结论:三角肌挛缩症患儿行挛缩带近端松解术后,恢复关节的功能和正常的肩关节位置关系就显得特别重要,功能锻炼是达到最终治疗目的的重要手段。

儿童巨大桥小脑肿瘤手术的围手术期护理

目的总结儿童巨大桥小脑肿瘤手术的护理质量控制，保证术中护理质量。 方法回顾性总结2012年1月－2013年3月18例儿童巨大桥小脑肿瘤手术，了解术前家长担心的问题，术前麻醉、皮肤的准备，术中皮肤护理、体温护理等手术室护理质量管理的相关环节，根据围手术期患儿的应激特点及患儿自身特征，以及手术要求，实施有针对性的术前、术中、术后护理。 结果18例儿童巨大桥小脑肿瘤手术体位安全，暴露充分，术者满意，手术时间8.33～11.66 h，平均10.42 h，出血量100～300 mL，未因手术体位的摆放和护理因素而发生并发症。术后1 d恢复良好，格拉斯哥昏迷评分9～12分。 结论在行儿童巨大桥小脑肿瘤手术时，根据围手术期患儿的应激特点及患儿自身特征，以及手术要求，实施有针对性的术前、术中和术后护理，可使手术野暴露充分，保证术中护理质量，减少手术并发症。

The Nursing Experience of Preoperative Treatment for Urethral Injury with Ureteroscopic Urethral Realignment

ObjectiveTo explore the nursing experience of preoperative treatment for urethral injury with ureteroscopic urethral realignment. MethodsThe key points of the nursing experience of preoperative treatment for 58 cases of urethral injury with ureteroscopic urethral realignment were retrospectively analyzed. The patients were treated between January 2008 and December 2012. ResultsUrethra catheterization of the 58 patients receiving the ureteroscopic urethral realignment was all successful. The catheter was extracted 4-8 weeks after the treatment, and then the urethra was dilated for two years. All patients had normal urination without any surgery complications during the 5-28-month clinical follow-up. ConclusionUrinary tract infections can be prevented effectively under professional and meticulous preoperative treatment. The incidence of urethral stricture can be reduced greatly. The quality of the patients' life can be improved a lot.

新生儿先天性巨结肠根治术的围术期护理

【摘要】　目的　总结新生儿先天性巨结肠的围术期护理。　方法　对2008年1月-2009年7月收治的30例先天性巨结肠患儿术前、术中及术后的护理资料进行回顾性分析。　结果　30例患儿手术成功，经精心护理均痊愈出院，达到预期的效果。　结论　先天性巨结肠在新生儿时期即行根治手术，手术前后的护理是治疗的重要环节。术前予以肠道的准备充分、术后采取精心对症的护理措施，加强病情观察，加强营养支持，重视肛周护理，是保证手术成功的重要因素。

Ⅲ型先天性食道闭锁患儿围手术期护理

目的　总结Ⅲ型先天性食道闭锁患儿的围手术期的监护方法与经验。 方法　对2010年1月－12月收治的9例Ⅲ型先天性食道闭锁、拟行食道闭锁I期吻合术及食管气管瘘结扎术患儿，围手术期予以体位、气道、管道、保暖、营养支持等有效护理措施，并积极预防相关并发症。 结果　患儿平均住院22 d，7例患儿痊愈，1例术后自动出院，1例死亡。随访1年，患儿恢复良好，2例食道吻合口狭窄患儿，经食道球囊扩张后治愈。 结论　利用体位及食道盲端负压引流技术，能很好地防止患儿术前肺炎加重。严密的监测、预防和处理并发症、气道管理、营养支持等综合监护措施是先天性食道闭锁患儿手术成功和身体康复的重要保证。

经眼上静脉栓塞治疗外伤性颈动脉海绵窦瘘的围手术期护理

目的探讨经眼上静脉路径，栓塞治疗外伤性颈动脉海绵窦瘘 (TCCF) 的围手术期的护理。 方法对 1998年 10月－2010年 9月收治的 13例眼上静脉动脉化 TCCF 患者行微弹簧圈栓塞治疗，并对术前、术中、术后规范护理措施及方法进行总结。 结果12例术后造影瘘口消失且颈内动脉通畅，颅内杂音消失，经过围手术期的精心护理，突眼、眼外肌运动受限和球结膜肿胀 1 周内基本消失。1 例填入 5枚弹簧圈后，微导管脱离瘘口，术中造影瘘口仍显示，1 周后球囊阻断实验阴性后闭塞颈内动脉主干，患者临床症状消失。术后 3～12 个月对10例患者进行脑血管造影复查，仅1例复发。 结论对于球囊闭塞困难的外伤性颈动脉海绵窦瘘，且眼上静脉动脉化患者，采用微弹簧圈栓塞治疗安全、有效。做好围手术期的护理，对提高治疗效果、预防并发症有重要意义。

Development and application of a multidisciplinary nursing program for Prader-Willi syndrome with spinal deformity in perioperative period

Objective To develop a multidisciplinary nursing program for Prader-Willi syndrome with spinal deformity and evaluate its effectiveness in clinical practice. Methods In July 2016, a multidisciplinary collaborative team was established before the treatment of children with Prader-Willi syndrome complicated with spinal deformity. For the nursing difficulties in the perioperative period, relevant literature was consulted, and a multidisciplinary collaborative nursing plan was formulated, which included nutrition management and blood glucose control, management of obstructive sleep apnea hypopnea syndrome, behavioral intervention related to mental change, and early identification and management of complications. The developed multidisciplinary collaborative nursing program was applied to three children with Prader-Willi syndrome complicated with spinal deformity in Peking Union Medical College Hospital from July 2016 to October 2018, and their postoperative recovery was evaluated. Results One child had inguinal skin ulceration when admitted to hospital, which was significantly improved after active treatment. The perioperative blood glucose level control of the three children was satisfactory, and there was no postoperative gastrointestinal dysfunction, deep wound infection, respiratory complications, internal fixation failure or other complications, and no asphyxia, fall, loss, or other adverse events. The follow-up compliance after discharge was 100%. Conclusions Multidisciplinary collaboration programs can escort patient’ safety and promote their recovery, improve the professional level of nursing staff, and reflect the nursing value. As a working mode, it can be further popularized and used for reference in the nursing of other difficult diseases.