CAJ | 학술논문

目的：总结3例新生儿先天性膈疝子宫外产时处理术前及术中护理要点。方法本组3例产妇均在气管插管全身麻醉下，行子宫下段剖宫产术，胎头娩出后即给予气管插管，建立有效气道通气及外周血液循环，转到相邻手术台行新生儿膈疝修补术；护理方面做好术前准备，术中建立新生儿手术区，抑制产妇宫缩、做好产妇及新生儿保暖工作，密切观察生命体征。结果3例剖宫产产妇手术时间和出血量分别为：65 min，400 ml；80 min，500 ml；90 min，500 ml，新生儿膈疝修补术时间分别为：80min、80min、70min，3例产妇及新生儿手术顺利，均无不良并发症发生。结论先天性膈疝产时子宫外处理术前要做好患者及家属心理护理，进行多学科会诊，术中迅速建立新生儿手术区，协助产妇抑制宫缩，尽量延长胎盘循环时间，确保新生儿膈疝修补术顺利进行。
목적：총결3례신생인선천성격산자궁외산시처리술전급술중호리요점。방법본조3례산부균재기관삽관전신마취하，행자궁하단부궁산술，태두면출후즉급여기관삽관，건립유효기도통기급외주혈액순배，전도상린수술태행신생인격산수보술；호리방면주호술전준비，술중건립신생인수술구，억제산부궁축、주호산부급신생인보난공작，밀절관찰생명체정。결과3례부궁산산부수술시간화출혈량분별위：65 min，400 ml；80 min，500 ml；90 min，500 ml，신생인격산수보술시간분별위：80min、80min、70min，3례산부급신생인수술순리，균무불량병발증발생。결론선천성격산산시자궁외처리술전요주호환자급가속심리호리，진행다학과회진，술중신속건립신생인수술구，협조산부억제궁축，진량연장태반순배시간，학보신생인격산수보술순리진행。
Objective To report 3 cases of using the EXIT(ex-utero intrapartum treatment)procedure in the peri-surgical caring of congenital diaphragmatic hernia of neonatus.Methods Preparing and consulting of multiple clinical departments before operation,inhibit uterine contraction to avoid placental abruption.Keep puerperae and their babies warm.Result No complications happened to neither maternity nor neonatus.Conclusion Co-operations of multiple clinical departmens were essential to the successful using the EXIT(ex-utero intrapartum treatment)procedure in the congenital diaphragmatic hernia of neonatus.