手助腹腔镜全结肠切除术回肠储袋治疗家族性腺瘤性息肉病患者的术后并发症及护理

赵惠英; 徐海娟; 徐加鹤; 陈文斌

doi:10.3760/cma.j.issn.1672-7088.2016.25.009

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中国实用护理杂志

• 临床护理•外科护理 •

ENGLISH ABSTRACT

手助腹腔镜全结肠切除术回肠储袋治疗家族性腺瘤性息肉病患者的术后并发症及护理

作者及单位信息

出版日期： 2016 -09 -01 ·

DOI： 10.3760/cma.j.issn.1672-7088.2016.25.009

The postoperative complications and nursing experience of hand assisted laparoscopic J-type ileal pouch-anal anastomosis in familial adenomatous polyposis

Authors Info & Affiliations

Zhao Huiying

Xu Haijuan

Xu Jiahe

Chen Wenbin

Department of Colorectal Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine; Center for Diagnosis and Treatment of Colorectal Diseases, Zhejiang Province, Hangzhou 310003, China

Published： 2016 -09 -01 ·

DOI： 10.3760/cma.j.issn.1672-7088.2016.25.009

241

APP内阅读

摘要

目的总结家族性腺瘤性息肉病（FAP）患者行手助腹腔镜下全结肠切除J型回肠储袋-肛管吻合术（IPAA）术后并发症及其护理体会。

方法对我科36例行IPAA的FAP患者进行回顾性分析。

结果2例于术后出现回肠储袋出血，3例女性患者术后出现尿潴留，3例术后外痔水肿明显，2例出现吻合口瘘，经过相关治疗及护理，均好转出院，在术后随访中有6例出现储袋炎，经过积极治疗后好转。

结论FAP患者行IPAA，手术难度大，容易出现并发症，护理难度大，加强围手术期护理，可减少并发症的发生，提高患者的生命质量。

关键词：护理;家族性腺瘤性息肉病;手助腹腔镜;全结直肠切除回肠储袋-肛管吻合术

ABSTRACT

ObjectiveTo investigate the postoperative complication and nursing experience of hand-assisted laparoscopic J-type ileal pouch-anal anastomosis (IPAA) in familial adenomatous polyposis (FAP).

MethodsA total of 36 patients with FAP who had undergone hand-assisted laparoscopic J-type ileal pouch-anal anastomosis (IPAA) were analyzed retrospectively.

ResultsThe postoperative complication included ileal pouch bleeding in 2 cases, urinary retention in 3 female patients, external hemorrhoids swelling in 3 cases, and anastomotic fistula in 2 cases. Six cases had ileum pouch inflammation during the postoperative follow-up. All the complications were relieved after conservative medical therapy.

ConclusionsIPAA operation puts forward high technical requirements with more postoperative complications. Therefore, it is important to strengthen nursing of the patients, reduce postoperative complication and increase quality of life of FAP.

KEYWORDS： Nursing;Familial adenomatous polyposis;Hand-assisted laparoscopic;Ileal pouch-anal anastomosis

Corresponding author: Chen Wenbin, Email: mocdef.labiamtohnibwc

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All articles published represent the opinions of the authors, and do not reflect the official policy of the Chinese Medical Association or the Editorial Board, unless this is clearly specified.

引用本文

赵惠英,徐海娟,徐加鹤,等. 手助腹腔镜全结肠切除术回肠储袋治疗家族性腺瘤性息肉病患者的术后并发症及护理[J]. 中国实用护理杂志,2016,32(25)：1956-1958.

DOI:10.3760/cma.j.issn.1672-7088.2016.25.009

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版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

家族性腺瘤性息肉病（familial adenomatouspolyposis，FAP）是最常见的常染色体显性遗传性大肠息肉病之一，遗传符合Mendelian定律，其患者下一代中有50％左右的受累危险 ^{[
1
]}。本病发病年龄早，如不进行预防性手术治疗，多数患者在40岁左右发生癌变，故临床上对FAP患者进行预防性全结肠切除治疗已达成共识 ^{[
2
]}。本病开腹手术创伤较大，手助腹腔镜下行全结肠切除J型回肠储袋-肛管吻合术（ileal pouch-anal anastomosis, IPAA）创伤较小，术后并发症较少，但手术难度大。本研究回顾性分析2013年6月至2015年6月我科开展IPAA治疗36例FAP患者，疗效满意，现报道如下。

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备注信息

通信作者：陈文斌，Email ： mocdef.labiamtohnibwc

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