尿道下裂小儿Ⅰ期尿道成形术的护理体会  

Nursing experience of one-stage urethroplasty for children with hypospadias

作　　者：谢小玲[1] 祝妍华[1] 

机构地区：[1]广东省深圳市龙岗中心医院手术室,广东深圳518116

出　　处：《中国医药导报》2015年第32期150-153,共4页China Medical Herald

摘　　要：目的探讨尿道下裂小儿Ⅰ期尿道成形术的护理体会。方法回顾性分析于2012年12月~2014年10月在浙江省舟山市妇幼保健院行Ⅰ期尿道成形术的尿道下裂患儿66例的护理资料,包括术前护理、手术配合、术后护理、出院指导等。观察患儿的排尿情况、尿道外口的位置、阴茎和龟头的外观等方面,对其效果进行综合评分。结果本组66例尿道下裂行Ⅰ期尿道成形术患儿术后均获得满意的外观,所有患儿均于术后1~2周内拔除尿管,综合评分为（4.5±1.2）分;经护理,自由尿流率升高,压力流率降低,护理前后自由尿流率及压力流率组内比较差异均有统计学意义（t=7.72、8.01,均P〈0.05）;护理前,自由尿流率明显低于压力流率（t=8.30,P〈0.05）,护理后,自由尿流率与压力流率比较差异无统计学意义（t=1.34,P〉0.05）;术后出现并发症8例（12.1%）,其中尿瘘3例,尿道吻合狭窄3例,排尿困难2例。经过针对性的护理,患儿并发症均恢复良好。结论对行尿道成形术的尿道下裂患儿进行术前、术中及术后的精心护理可以有效减少术后并发症,提高手术成功率,是手术成功的保障。Objective To investigate the nursing experience of one-stage urethroplasty for children with hypospadias.Methods The nursing data of 66 children with hypospadias who took one-stage urethroplasty from December 2012 to October 2014 in the Maternal and Child Health Hospital in Zhoushan City of Zhejiang Province was analyzed retrospectively, including preoperative care, surgery cooperation, postoperative care, discharge guidance and so on. The urinating condition, the location of external urethral orifice, the appearance of penis and glans and other aspects of children were observed, and the comprehensive score of effect was performed. Results All 66 children with hypospadias in our group who took one-stage urethroplasty obtained satisfactory appearance after operation, all children took catheter removal after surgery within 1-2 weeks, the comprehensive score was（4.5±1.2） points. Through nursing, free urine flow rate increased, pressure flow rate reduced, the differences of free urine flow rate and pressure flow rate before and after nursing were all statistically significant（t = 7.72, 8.01, all P〈0.05）; before nursing, free urine flow rate was significantly lower than the pressure flow rate（t = 8.30, P〈0.05）, after nursing, the free urine flow rate and the pressure flow rate had no statistically significant difference（t = 1.34, P〉1.34）. After nursing, there were 8 cases（12.1%） of children with complications, among whom, 3 children had urinary fistula, 3 children had urethral anastomosis stricture and 2 children had dysuria. Through targeted nursing, the complications were recovered well. Conclusion Preoperative, intraoperative and postoperative meticulous nursing for children with hypospadias who take one-stage urethroplasty can reduce postoperative complications effectively, improve the success rate of the surgery, which is the guarantee of successful surgery.

关 键 词：尿道下裂 尿道成形术 小儿 护理 

分 类 号：R473.72[医药卫生—护理学]