[先天性巨结肠术后肛门护理的临床对比] 先天性巨结肠术后如何收缩肛门

　　[摘要] 目的 探讨3M无痛保护膜与红外线烤灯在先天性巨结肠术后肛门护理中的应用对比。 方法 将160例行先天性巨结肠术后的患儿随机分成两组，其中对照组80例，患儿术后拔除肛管后肛门用生理盐水棉球擦拭和红外线灯烤进行护理，实验组80例，患儿术后拔除肛管后用3M无痛保护膜喷涂肛门皮肤，并进行暴露。 结果 实验组使用3M无痛保护膜在皮肤潮红方面与对照组比较有较好的作用（P = 0.001），起到了有效保护皮肤及促进皮肤愈合的目的，可有效增加患儿的舒适度，减轻护理人员及家属的负担，提高患儿及家属的满意度，两组患儿家属主观感受评分比较差异均有统计学意义（均P ＜ 0.05）。 结论 3M无痛保护膜方便实用，可广泛应用于临床护理工作。
　　[关键词] 先天性巨结肠；肛门；护理；3M无痛保护膜
　　[中图分类号] R473.6 [文献标识码] C [文章编号] 1673-7210（2012）08（b）-0123-02
　　Clinical comparison of anus nursing intervention after congenital megacolon surgery
　　YANG Fan1 ZANG Shuang2 HU Xiaoyun3 FAN Ling4▲
　　1.Department of Pediatric Teaching, the Shengjing Hospital Affiliated to China Medical University, Liaoning Province, Shenyang 110004, China; 2.College of Nursing, the China Medical University, Liaoning Province, Shenyang 110001, China; 3.Department of Pediatric General Surgery, the Shengjing Hospital Affiliated to China Medical University, Liaoning Province, Shenyang 110004, China; 4.Department of Nursing, the Shengjing Hospital Affiliated to China Medical University, Liaoning Province, Shenyang 110004, China
　　[Abstract] Objective To investigate the comparison of the 3M pain-free protective film and the infrared heat lamp for anal nursing care application of the congenital megacolon. Methods 160 children in our department were randomly divided into two groups. Children postoperatively were used cotton balls with normal saline to clean the anus after removal of the anal canal and used infrared heat lamp for care in the control group of 80 cases. Children postoperatively were used 3M pain-free protective film to spurt the anal skin for care after removal of the anal canal and exposed the anus in the experimental group of 80 cases. Results Experimental group used 3M pain-free protective film had a good effect in the skin flushing when compared with that of control group (P = 0.001), which effectively protected the anal skins and promoted healing. 3M pain-free protective film effectively increased the children"s degree of comfort, reduced the burden on the nursing staff and families and improved the satisfaction of children and their families, there were significant difference in the score of subjective feeling between the children’ families of two group (P ＜ 0.05). Conclusion 3M pain-free protective film is convenient and practical and can be widely used in clinical nursing care.
　　[Key words] Congenital megacolon; The anus; Nursing; 3M pain-free protective film
　　先天性巨结肠是小儿常见的先天性肠道发育畸形。其病因是结肠远端及直肠缺乏神经节细胞，直肠或结肠远端的肠管持续痉挛，粪便淤滞在近端结肠，使该肠管肥厚、扩张。临床表现为不全性或完全性结肠梗阻，多数病变局限于乙状结肠或直肠，少数可累及全结肠或全消化道[1]，主要以手术治疗为主，而术后有效的肛门护理可以减少并发症的发生。作者使用3M无痛保护膜，采用喷涂肛门皮肤的护理方法，效果显著，不但起到了保护皮肤的作用，而且提高了患儿的舒适度，减轻了家属的负担。