Abstract:
Objective To investigate the effect of thoracoscopic diaphragmatic hernia repair for neonates with congenital diaphragmatic hernia on perioperative monitoring and nursing methods.
Methods A total of 48 neonates with congenital diaphragmatic hernia admitted to Rugao People's hospital from October 2015 to October 2019 were selected and divided into observation group and control group. The children in the observation group received thoracoscopic diaphragmatic hernia repair and perioperative monitoring and nursing, while the children in the control group received traditional open surgery. Blood gas indexes were closely monitored during the operation, with emphasis on the changes of arterial blood partial pressure of carbon dioxide (PaCO2), pH, lactic acid and other indexes.
Results All cases successfully completed the operation. The operative time of the experimental group and the control group was (118.51±18.75) minutes vs (135.13±30.19) minutes, respectively, and the difference was statistically significant (P<0.05). Intraoperative PaCO2, pH and lactic acid in the observation group and the control group were (49.00±9.36) mmHg vs (38.12±4.34) mmHg, (7.26±0.26) vs (7.39±0.16), (0.87±1.41) mmol/L vs (0.63±0.86) mmol/L, respectively, the differences were statistically significant (P<0.05). The duration of mechanical ventilation was (47.39±10.32) hours in the observation group and (117.81±19.63) hours in the control group, respectively, and the difference was statistically significant (P<0.05). The observation group had postoperative pneumothorax in 2 cases and pleural effusion in 1 case, and the control group had postoperative pneumothorax in 5 cases and pleural effusion in 2 cases, the difference being statistically significant (P<0.05). Two groups of children were followed up for 9-13 months. During the follow-up, there was no recurrence or death.
Conclusion The therapeutic effect of thoracoscopic treatment of neonatal congenital diaphragmatic hernia is certain, but it will increase the difficulty of perioperative nursing, and on the premise of ensuring the quality of nursing monitoring, the incidence of postoperative complications and mortality can be reduced.
Key words:
Newborns,
Congenital diaphragmatic hernia,
Perioperative period,
Nursing
Rui Hua, Cuiliu Zhang, Zhiyong Huang. Comparative study on the effect of thoracoscopic treatment of neonatal congenital diaphragmatic hernia on perioperative nursingcare[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(02): 211-214.