出口梗阻型便秘STARR术围手术期的护理  

Perioperative Nursing of STARR for Outlet Obstruction Constipation Patients

作　　者：何娟[1] 罗菊桃[1] 

机构地区：[1]湖南省郴州市第一人民医院肛肠外科,郴州423000

出　　处：《中国现代手术学杂志》2013年第6期465-467,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的总结出口梗阻型便秘行经肛双吻合器直肠前后壁粘膜切除术（stapled transanal rectal resection，STARR）的围手术期护理。方法2012年1月至2012年6月于湖南省郴州市第一人民医院肛肠外科因出口梗阻型便秘收住院的总共132例，平均年龄51．36（21～81）岁，其中男性43例，平均年龄54．72（21～81）岁；女性89例，平均年龄49．74（22～80）岁。经排粪造影、肛管测压、结肠运输试验、结肠镜检，确诊为出口梗阻型便秘。其中合并混合痔93例，肛乳头瘤52例，盆底松弛综合症89例、盆底失驰缓综合症63例，均施行STARR术。围术期护理包括术前心理护理、一般护理、术后体位及尿管护理、疼痛护理、输液护理、饮食及排便护理、肛门理疗及坐浴护理、出院指导。结果患者住院满意度达100％。术后6～12个月随访，77％的患者术后排便通畅，无肛门坠胀及不尽感，12％患者偶尔出现排便困难，通过饮食调节可缓解。11％患者自觉排便状态无明显改善。结论针对不同患者找出护理的关键所在，有重点地采取相应的护理措施，将达到事半功倍的效果。Objective To summarize the perioperative nursing experiences of STARR in the outlet obstruction constipation patients. Methods A total of 132 cases, with an average age of 51.36 （21 - 81 ） years, including 43 cases of male, the average age of 54.72 （21 -81 ） years and 89 females, the average age of 49.74 （22 ~ 80） years were hospitalized for outlet obstructive constipation from January 2012 to June 2012 in Department of Colorectal Surgery, the First Peopleg Hospital of Chenzhou. By defecography, anorectal manom- etry, colonic transit test and colonoscopy, all the cases were diagnosed with outlet obstruction constipation. The complications included 93 patients with mixed hemorrhoids, anal papilla tumor 52 cases, relaxed pelvic floor syndrome 89 cases, and unrelaxed pelvic floor syndrome 63 cases. All the patients underwent STARR. The perioperative nursing of STARR included psychological nursing before operation, general nursing, the body pos- ture and ureter nursing, ache nursing, infusion nursing, the diet and bowel movement nursing, the anus physi- cal therapy and sitz bath nursing, and discharge guidance. Results The satisfaction rate of all the hospital- ized patients was 100%. After 6 N 12 months follow-up, 77% patients felt defecation smooth, no anal bulge or endless feeling, only 12% patients occasionally occurred difficult defecation which could alleviate by the regula- tion of diet. And 11% patients felt no obvious improvement. Conclusion It is the key points of the periopera- tive nursing of STARR for the outlet obstruction patients of the individualized care and the appropriate measures.

关 键 词：出口梗阻型便秘 围手术期护理 

分 类 号：R473.6[医药卫生—护理学]