3例新生儿先天性膈疝子宫外产时处理术前及术中护理

摘要

目的：总结3例新生儿先天性膈疝子宫外产时处理术前及术中护理要点。方法本组3例产妇均在气管插管全身麻醉下，行子宫下段剖宫产术，胎头娩出后即给予气管插管，建立有效气道通气及外周血液循环，转到相邻手术台行新生儿膈疝修补术；护理方面做好术前准备，术中建立新生儿手术区，抑制产妇宫缩、做好产妇及新生儿保暖工作，密切观察生命体征。结果3例剖宫产产妇手术时间和出血量分别为：65 min，400 ml；80 min，500 ml；90 min，500 ml，新生儿膈疝修补术时间分别为：80min、80min、70min，3例产妇及新生儿手术顺利，均无不良并发症发生。结论先天性膈疝产时子宫外处理术前要做好患者及家属心理护理，进行多学科会诊，术中迅速建立新生儿手术区，协助产妇抑制宫缩，尽量延长胎盘循环时间，确保新生儿膈疝修补术顺利进行。%Objective To report 3 cases of using the EXIT(ex-utero intrapartum treatment)procedure in the peri-surgical caring of congenital diaphragmatic hernia of neonatus.Methods Preparing and consulting of multiple clinical departments before operation,inhibit uterine contraction to avoid placental abruption.Keep puerperae and their babies warm.Result No complications happened to neither maternity nor neonatus.Conclusion Co-operations of multiple clinical departmens were essential to the successful using the EXIT(ex-utero intrapartum treatment)procedure in the congenital diaphragmatic hernia of neonatus.