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目的:总结新生儿先天性膈疝围手术期的护理经验,以提高先天性膈疝患儿的抢救成功率和生存质量。方法:回顾性分析12例先天性膈疝在不同手术时机里加强生命体征监测及保暖,同时做好呼吸道管理、胸腔引流管、胃管及切口等护理。结果:重症组中紧急手术组存活率为60.0%,延期手术组存活率为75.0%;一般组中紧急手术组及延期手术组均存活。术后并发肺部感染2例,新生儿硬肿症1例,切口感染1例,3例死于呼吸窘迫综合征。结论:早期诊断、早期手术治疗和术后精心护理是手术成功的关键。
Objective: To summarize the perioperative nursing experience of neonatal congenital diaphragmatic hernia in order to improve the rescue success rate and quality of life of children with congenital diaphragmatic hernia. Methods: Retrospective analysis of 12 cases of congenital diaphragmatic hernia in different timing of surgery to enhance vital signs monitoring and warmth, and good respiratory management, chest drainage tube, gastric tube and incision care. Results: The survival rate of emergency operation group was 60.0% in severe group and 75.0% in delayed operation group. The emergency group and delayed operation group survived in general group. Postoperative pulmonary infection in 2 cases, neonatal scleroderma in 1 case, incision infection in 1 case, 3 patients died of respiratory distress syndrome. Conclusion: Early diagnosis, early surgery and meticulous care are the keys to successful operation.