夏红霞 王芳 廖晓锋 王玉珍

[摘要] 目的 探讨综合护理干预对Duhamel改良手术治疗先天性巨结肠的效果。 方法 选取2016年1月～2017年6月湖北省襄阳市中心医院收治的80例先天性巨结肠患兒，采用随机数字表法分为观察组和对照组，每组各40例，两组均行Duhamel改良手术，对照组给予常规护理，观察组给予综合护理干预。比较两组疗效、并发症发生率及护理满意度。 结果 观察组有效率为95.0%，对照组为90.0%，差异无统计学意义（P > 0.05）；观察组并发症发生率（5.0%）低于对照组（30.0%），差异有高度统计学意义（P < 0.01）。观察组满意率（97.50%）高于对照组（62.50%），差异有高度统计学意义（P < 0.01）。护理后，观察组组生活质量评分[（58.66±5.28）分]显著高于对照组[（47.41±5.37）分]，差异有统计学意义（P < 0.05）。 结论 综合护理配合Duhamel改良手术疗效确切，能显著降低并发症发生率，提高患儿及家属满意度值得推广应用。

[关键词] 综合护理；先天性巨结肠；疗效

[中图分类号] R473.72 [文献标识码] A [文章编号] 1673-7210（2018）04（a）-0158-04

[Abstract] Objective To investigate the effect of comprehensive nursing care on Duhamel modified surgery for Hirschsprung's disease. Methods From January 2016 to June 2017， in Xiangyang Centrol Hospital， 80 Hirschsprung disease children were selected， according to random number table method， they were divided into observation group and control group， with 40 cases in each group， the two groups underwent modified Duhamel surgery， the control group received routine nursing， the observation group received nursing intervention. The curative effect， complication rate and nursing satisfaction of the two groups were compared. Results The total effective rate in the observation group was 95%， that in the control group was 90%， the difference was not statistically significant （P > 0.05）； the complication rate in the observation group （5%） was that lower than that in the control group （30%）， the difference was statistically significant （P < 0.01）. The total satisfaction rate in the observation group （97.50%） was lower than that in the control group （62.50%）， the difference was statistically significant （P < 0.01）. After nursing， the quality of life scores in the observation group [（58.66±5.28） scores] was higher than that in the control group [（47.41±5.37） scores]， the difference was statistically significant （P < 0.05）. Conclusion The comprehensive nursing effect of modified Duhamel operation is effective， it can significantly reduce the incidence of complications， improve the satisfaction of patients and their families and it is worthy of popularization and application.

[Key words] Comprehensive care； Congenital megacolon； Curative effect

先天性巨结肠是小儿常见的先天性消化系统疾病之一，以出生后排胎便延迟、顽固性便秘、腹胀为主要特点，严重影响患儿的身心健康。如不及时治疗，易反复出现小肠结肠炎，严重者出现败血症等，危及生命。先天性巨结肠主要治疗方法是Duhamel术，由于吻合口狭窄和吻合口漏等并发症的存在，目前国内外多使用Duhamel改良手术，同时辅以护理干预[1]。随着手术方式的改良和患者对医疗质量要求的提高，围术期有效护理日益被重视，常规护理已不能满足围术期护理需要，有效的护理措施能保障手术治疗效果及术后恢复[1]。本研究选取湖北省襄阳市中心医院（以下简称“我院”）收治的先天性巨结肠患儿为研究对象，探讨综合护理配合Duhamel改良手术的治疗效果，现报道如下：

1 资料与方法

1.1 一般资料

选取2016年1月～2017年6月我院收治的80例先天性巨结肠患儿，采用随机数字表法分为观察组和对照组，每组各40例。观……