CAJ | 학술논문

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.
목적 총결문정맥해면양변병소화도출혈환인행원단비신분류술적호리요점.방법 대3례문정맥해면양변병소화도출혈환인술전주호상소화도출혈적호리,가강영양지지;술후가강혈전화출혈등병발증적방범공작,감측뇨량화뇨밀도,주호동맥측압관적호리,중시출원지도화수방공작.결과 본조3례환인술후균출현불동정도적혈소판증고,1례환인출현복강소량출혈,경대증처리후호전,1례환인수주정맥고영양액발생정맥류치침처삼루;3례환인출원후근종수방3개월～3년,무간、신공능이상급혈전등병발증발생.결론 소인문정맥해면양변비신분류술림상비상소견,주호위수술기호리화가강술후병발증적관찰,중시출원지도화수방공작시치료성공적보증.
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.