小儿腹腔镜手术气腹相关并发症发生的原因和护理

摘要

目的 探讨小儿腹腔镜手术气腹相关并发症发生的原因,并提出相应的护理措施.方法 回顾性分析120例行腹腔镜手术患儿的临床资料,总结气腹相关并发症发生的原因和预防措施.结果 120例腹腔镜手术患儿共发生气腹相关并发症16例,其中胃内容物反流6例、呼吸性酸中毒4例、体温下降3例、气管导管移位3例;无1例发生气胸、纵膈气肿、气体栓塞、心包积气等与气腹相关的严重并发症.结论 采用最小的气腹压力是预防胃内容物反流、高碳酸血症和呼吸性酸中毒的主要措施,做好体位护理、固定好气管导管和注意保暖及使用加温的CO<,2>2充气对预防胃内容物反流、体温下降和气管导管移位的发生具有积极的意义.%Objective To explore the causes of pneumoperitoneun complications during pediatric laparoscopic surgery and to put forward the pertinent nursing measures.Method A retrospective analysis was conducted on 120 patients undergoing pediatric laparoscopic surgery, and the nursing measurea of preventing pneumoperitoneum correlative complications were aummarized.Results Sixteen patients had pneumoperitoneum conelative complications, including gastric contents back-streaming in 6 patients, respiratory acidosis in 4, temperature drop in 3 and shift of trachea duct in 3.No major pneumoperitoneum correlative complications happened, such as pneumothorax, mediastinal emphesema, gas embolism or pneumopericardium.Conclusions Using a minimal pneumoperitoneum pressure is the main nursing measure to avoid gastric contents back-streaming, hypercapnia and respiratory acidosis.Meanwhile, body position nursing, fixing the trachea duct, keeping body wann and using warming CO2 to aerate are important to prevent the incidence of gastric contents back-streaming, temperature drop and shift of trachea duct.