小儿门静脉海绵样变并消化道出血行远端脾肾分流术的围手术期护理  

Peri-operative nursing of infants with cavernous transformation of the portal vein and gastrointestinal bleeding undergoing distal splenorenal shunt

作　　者：刘新文[1] 何小琼[1] 甘红霞[1] 

机构地区：[1]武汉市妇女儿童医疗保健中心,430016

出　　处：《中国实用护理杂志》2014年第28期35-37,共3页Chinese Journal of Practical Nursing

摘　　要：目的 总结门静脉海绵样变并消化道出血患儿行远端脾肾分流术的护理要点.方法 对3例门静脉海绵样变并消化道出血患儿术前做好上消化道出血的护理,加强营养支持;术后加强血栓和出血等并发症的防范工作,监测尿量和尿密度,做好动脉测压管的护理,重视出院指导和随访工作.结果 本组3例患儿术后均出现不同程度的血小板增高,1例患儿出现腹腔少量出血,经对症处理后好转,1例患儿输注静脉高营养液发生静脉留置针处渗漏;3例患儿出院后跟踪随访3个月～3年,无肝、肾功能异常及血栓等并发症发生.结论 小儿门静脉海绵样变脾肾分流术临床非常少见,做好围手术期护理和加强术后并发症的观察,重视出院指导和随访工作是治疗成功的保证.Objective To summarize the nursing of infants with cavernous transformation of the portal vein （CTPV） and gastrointestinal bleeding undergoing distal splenorenal shunt.Methods 3 cases of infants with CTPV and gastrointestinal bleeding were given with preoperative nursing for upper gastrointestinal bleeding,strengthening nutritional support; strengthening prevention measures of thrombosis and bleeding complications,monitoring of urine and urine gravity,completing the artery piezometer tube care,paying attention to the discharge guidance and follow-up work.Results The platelet increased in 3 cases post-operation.1 cases occurred abdominal bleeding,but improved after symptomatic treatment.1 case occurred leakage on the site of venous indwelling needle during intravenous infusion of high nutrient solution.3 cases of children received 3 months to 3 years follow-up after discharge,no complications such as liver,kidney and blood clots occurred.Conclusions Infants with CTPV and gastrointestinal bleeding undergoing distal splenorenal shunt is very rare in clinic.Good perioperative care and strengthening the observation of the postoperative complications,attaching great importance to the discharge guidance and follow-up work,are the assurances of successful treatment.

关 键 词：儿童 门静脉 消化道出血 围手术期护理 

分 类 号：R473.72[医药卫生—护理学]