小儿急腹症手术指征观察及护理.docVIP

小儿急腹症手术指征观察及护理【摘要】　目的：探讨小儿急腹症的具有手术指征的临床观察和护理。方法：回顾性分析本院2007~2011 年收治的小儿急腹症治疗病例，其中保守治疗107例，手术患者44例，病情观察和护理包括生命体征、 腹痛和腹部体征、胃肠道症状、躯体姿势和表情的变化、患儿常规检查的准备等。结果：所有患儿得到正确的诊断和治疗，疗效满意。结论：正确的临床观察护理，及时筛选出需要手术的患者，把握手术时机，及时剖腹探查对减少急腹症患儿的并发症具有重要的临床意义。 【关键词】　小儿急腹症；　护理；　 手术指征 Care and Clinical Observation of the Indications for Surgery of Children Acute Abdomen/WANG Man-lin，WANG Ai-min.//Medical Innovation of China，2012，9(28):043-044 【Abstract】　Objective：Investigate care and the surgical indication of children acute abdomen with clinical observation.Method:Retrospective analysis of children cases of acute abdomen treatment were treated in our hospital from 2007 to 2011， including 107 cases of conservative treatment，43 cases of surgical patients，observation and nursing including vital signs， abdominal pain and abdominal signs，gastrointestinal symptoms， body posture and change of expression，children with the preparation of a routine examination.Result:All patients received timely and correct diagnosis and treatment，the results were satisfactory.Conclusion:Correct clinical observation and care，timely screening of patients who required surgery，and grasp in timing of surgery，timely laparotomy is important in reducing the complications of acute abdomen in children clinical significance. 【Key words】　Children acute abdomen;　Nursing ;　Surgical indications First-authors address: The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine，Jinan 250001，China doi：10.3969/j.issn.1674-4985.2012.28.025 小儿急腹症是儿科常见急症之一，器管发育不成熟，或因年龄因素不会或不能正确表达疾病的发病过程，往往很难把握保守治疗和手术治疗的指征，容易错过最佳的手术治疗时机，造成严重的不良后果，如腹膜炎、梗阻坏死、穿孔和出血等[1]。故临床上密切观察和护理对于手术指征患者的选择具有重要的意义。本院自2007-2011年共收治了小儿急腹症151例，其中保守治疗107例，手术患者44例，均得到了及时正确的诊断和治疗，疗效满意，现就临床体会探讨如下。 1　资料与方法 1.1　一般资料　本组共151例患者，男87例，女64例，年龄0~13岁；其中保守治疗107例，手术患者44例。 1.2　急腹症分类　本组手术患者中急性阑尾炎28例，肠套叠7例，腹股沟疝嵌顿6例，外伤性腹腔内出血2例，急性肠梗阻1例。 1.3　辅助检查　常规检查：均常规行血常规、尿常规、大便常规及肝、肾功能检查。凝血功能、腹部X线平片、B超，必要时行CT。 1.4　治疗方法　临床上根据患儿病史、体温、脉搏、呼吸等全身状况，观察有无休克、高热、失水、酸中毒；尽快选