Surgical nursing of neonatal megacolon

Every parent of a newborn baby hopes that their child can grow up healthy. However, there are so many problems for newborns. Every child is like this. For example, when a child is teething, he or she will have a fever. So, what about the surgical care for neonatal megacolon? Let me introduce it to you below. I hope this can help everyone.

Neonatal megacolon, also known as intestinal aganglionosis, is a common congenital intestinal malformation in children. It is caused by continuous spasm of the rectum or distal colon and fecal stagnation in the proximal colon, which causes hypertrophy and expansion of the intestine.

Nursing care for neonatal megacolon surgery

1. Preoperative care

Psychological care: Since the symptoms of megacolon in newborns are obvious and the condition is serious, manifested by abdominal distension, visible abdominal wall veins, difficulty in defecation, vomiting, etc., parents feel heartbroken to see their children suffering from the disease and hope that the disease can be cured with medicine. On the other hand, they do not understand the occurrence and development of the disease, are unfamiliar with the medical environment, and are not confident in medical technology, which often manifests as doubt, anxiety, fear, etc. At this time, we should use kind words and a friendly attitude to patiently and meticulously comfort the family members, and use our superb skills, excellent abilities and personal experiences of recovered cases to dispel their concerns and enable them to actively cooperate with the treatment with a good attitude.

2. Bowel Preparation

1. Anal dilation and defecation are performed to relieve symptoms. Soap bars and suppositories are usually used to stimulate the anus and rectum to induce defecation in children and relieve abdominal distension.

2. Cleansing and enema is an important nursing measure and also a conservative treatment method that is effective in relieving symptoms. After anal dilation for defecation, choose an anal canal of appropriate thickness and insert it from the anus. The depth must exceed the narrow section. The enema solution should be isotonic saline with a temperature of 39~41℃. Avoid using hypotonic solution to prevent water intoxication. Use anal suction method and pay attention to the balance of irrigation fluid. During irrigation, pay attention to observe the child's complexion, expression and abdominal condition. Keep warm in winter. Generally, enema is started one week before the operation, once a day.

3. Improve the nutritional status of children. Most children have a normal diet after enema. After a week of reasonable feeding, the nutritional status is significantly improved. If necessary, intravenous nutrition can be given.

4. Pre-operative preparation: Assist the physician in auxiliary examinations, introduce the anesthesia method, surgical approach, the purpose and significance of skin preparation, and the time and purpose of fasting from food.

3. Postoperative Care

1. Closely monitor changes in the patient's condition. Due to the influence of anesthesia, the patient's own physiological characteristics and other factors, the patient's condition changes rapidly after surgery and should be closely monitored. After returning to the room, the patient was immediately asked to lie flat without a pillow, with the head tilted to one side, shoulders raised, oxygen inhaled through a mask, oral secretions cleared promptly, ECG monitoring, and continuous monitoring of changes in heart rate, respiration, and blood oxygen saturation until they were stable.

2. Keep warm. Because the newborn's ability to regulate body temperature is weaker than that of adults and they are exposed for a long time during surgery, the body temperature of the child often does not rise after surgery. Place an incubator after surgery with the temperature set at around 33°C. If the body temperature still does not rise after 1 hour, gradually adjust the temperature to 35°C. Check the body temperature every 15 to 30 minutes. When the body temperature rises above 36°C, gradually adjust the temperature to around 30°C.

3. Diet: The patient is prohibited from eating for 24 to 48 hours after the operation. A clear liquid diet shall be given thereafter. Breastfeeding shall be conducted after 72 hours. Pay attention to observe whether the child has nausea, vomiting, or abdominal distension after eating.

4. Care of the drainage tube: After transanal radical surgery, an anal support tube is routinely placed. It should be properly fixed to prevent it from falling out. It should be squeezed regularly to prevent blockage. The area should be kept clean and dry, and removed after three days.

5. Care of the perianal skin: After the anal support tube is removed, the perianal skin will be irritated by the relatively frequent and thin stools, which may easily cause redness, swelling, and even erosion of the perianal skin. Therefore, care of the perianal skin is very important. After each bowel movement, you should wash with warm water, blow dry with a low-power hair dryer, apply povidone-iodine to the area for disinfection, and keep the perineum clean and dry.

The above is the content of surgical care for neonatal megacolon. After understanding the above, everyone should pay more attention to knowledge in this aspect. If the postoperative care is not proper, it is very likely to leave the child with a root of disease, and it will be too late to regret it then. For more knowledge, you can follow the editor at any time. The editor will continue to contribute sincerely to everyone.