英語護(hù)理查房第一頁，共52頁1234ContentsCaseReport

Knowledge

of

IntussusceptionTherapeutic

ManagementHealth

Guidance

forDischarged

Patients第二頁，共52頁

CaseReport第三頁，共52頁

BIOLOGICALDATA:

Name：ChenJingyaSex：femaleAge：7-month-oldDateofAdmission：2015-04-2314:40

CaseReport第四頁，共52頁

Chief

Complaint：

paroxysmalcrying

vomitingbloodystool

ERX-Ray:IntussusceptionunabletoresetCaseReport第五頁，共52頁

CaseReportAdmissionDiagnosis:AcuteIntussusceptionPhysicalExamination:T:36.9℃P:110/minR:20/minWt:7.5kg第六頁，共52頁Laboratoryexamination:routinebloodroutionurinefullbiochemicalfullbloodcoagulationtestHIV,HBV,HCV,RPRDateof

Intussusception

surgery:2015-04-23Dateofdischarge:2015-05-05

CaseReport第七頁，共52頁

Knowledge

of

Intussusception第八頁，共52頁EtiologySymptoms&SignsDefinitionIntussusception第九頁，共52頁

Whatisintussusception?

Intussusception

isamedicalconditioninwhichapartoftheintestinehasinvaginatedintoanothersectionofintestine.Knowledge

of

Intussusception--Definition第十頁，共52頁

Childrenintussusception

Intussusception

is

ancommonabdominalemergencyinchildren.Itisoneofthemostcommoncausesofabdominalobstructionininfants.4-10monthKnowledge

of

Intussusception--Definition第十一頁，共52頁

ETIOLOGY

Knowledge

of

Intussusception第十二頁，共52頁Age:80%<2yearsold,mostcommonininfants

aged4-10months.Sex:theratioofthemale-to-femaleis

approximately3:1.Season:theseasonalpeakisinspringandsummer.

Incidence:Knowledge

of

Intussusception--Etiology第十三頁，共52頁What’sthereasonofthedisease??Whyithappensto

infantsmostly??Knowledge

of

Intussusception--Etiology第十四頁，共52頁P(yáng)redisposingfactors:

caused

bydisorder

ofthe

intestinal

peristalsis,

suchas:Dietaryalteration:complementarysolidfood.Diseases:gastroenteritis,diarrhea,fever,etal.Virusinfections:adenovirus,rotavirus,reovirus,echovirus.Knowledge

of

Intussusception--Etiology第十五頁，共52頁Dietary

alterationKnowledge

of

Intussusception--Etiology第十六頁，共52頁The

complementary

food

of

children

can

notbechanged

too

soon.Itissupposedtobetransformedstepbystep.Dietary

alterationKnowledge

of

Intussusception--Etiology第十七頁，共52頁P(yáng)redisposingfactors:

caused

bydisorder

ofthe

intestinal

peristalsis,

suchas:Dietaryalteration:complementarysolidfood.Diseases:gastroenteritis,diarrhea,fever,etal.Virusinfections:adenovirus,

rotavirus,reovirus,echovirus.Knowledge

of

Intussusception--Etiology第十八頁，共52頁fever(acuteupperreappiratorytractinfection)lostitsnormalfunction/enterospasmDiseaseKnowledge

of

Intussusception--Etiology第十九頁，共52頁P(yáng)redisposingfactors:

caused

bydisorder

ofthe

intestinal

peristalsis,

suchas:Dietaryalteration:complementarysolidfood.Diseases:gastroenteritis,diarrhea,fever,etal.Virusinfections:adenovirus,rotavirus,reovirus,echovirus.Knowledge

of

Intussusception--Etiology第二十頁，共52頁Researcherssuspectthatinfectiousagents:rotavirus&adenovirus.Virus

infectionKnowledge

of

Intussusception--Etiology第二十一頁，共52頁Intussusceptioncauseshavenotclearlyestablishedorunderstood.Theycanincludeinfections,anatomicalfactors,andalteredmotility.Studiesandanalysis

havenotconclusivelyestablishedthis.Knowledge

of

Intussusception--Etiology第二十二頁，共52頁Areviewofsparsedataonthepossibleassociation:thevirus&intussusceptionhasnotdemonstrateduntilveryrecently.Knowledge

of

Intussusception--Etiology第二十三頁，共52頁SymptomsandSigns1、Generalappearance2、Paroxysmalcrying3、Biliousvomiting4、Redcurrantjellystool5、Sausage-shapedmassKnowledge

of

Intussusception第二十四頁，共52頁

TherapeuticManagement

NonsurgicalTherapySurgicalTherapy第二十五頁，共52頁NonsurgicalTherapy

AirEnemaBariumEnema第二十六頁，共52頁

NonsurgicalTherapy-BariumEnemaNonsurgicalTherapy---

BariumEnema第二十七頁，共52頁NonsurgicalTherapy-BariumEnemacomplicationchemical

peritonitisNonsurgicalTherapy---

BariumEnema第二十八頁，共52頁Intussusceptionpresenting<48hours.Goodgeneralappearance.Withoutabdominaldistention,hightemperatureandtoxicosis.ETIOLOGYNonsurgicalTherapy-AirEnema1.IndicationsNonsurgicalTherapy---

AirEnema第二十九頁，共52頁

2.Procedure

Restrainedthepatient,insertedtheFoleycatheterintorectum,inflatedtheballoon.NonsurgicalTherapy---

AirEnema第三十頁，共52頁2.headofintussusceptum

locatedinthehepatic

flexureofthecolon1.beforeairclysis3.reductionoccur4.reductiongoon5.thefillingofnumerousloopsofintestine第三十一頁，共52頁3.

SignsofCompleteReductionFreeflowofairintoseveralloopsofsmallbowelwithsimultaneousexpulsionoffeces.Stopcrying,bequiet.Disappearoftheabdominalmass.

NonsurgicalTherapy---

AirEnema第三十二頁，共52頁4.

NursingCareofPost-airenemaCarbontest:take0.5-1gactivatedcarbonorally,appearinginstool6-8hourslater.Basictherapy.Dietaryguidance.Clinicalobservationclosely.

NonsurgicalTherapy---

AirEnema第三十三頁，共52頁SurgicalTherapy

第三十四頁，共52頁

PuremanualreductionIntestinalanastomosisEterostomySurgicalTherapy

第三十五頁，共52頁1.SurgicalIndicationEnemafailure.Intussusceptionoccuringmorethan48-72hours.Intestinalnecrosis.Intestinalperforation.SurgicalTherapy

第三十六頁，共52頁

2.NursingDiagnosisPainAnxietyHight

riskforfluidvolumedeficitPotencialcomplicaion:shockSurgicalTherapy

第三十七頁，共52頁3.Postoperative

NursingInterventionMonitoringthevitalsignsandconsciousnessstate.Oralfeedingonagradualschedule----obeyingthedoctor’sinstruction.SurgicalTherapy

第三十八頁，共52頁Intensivecarefornasogastrictube.Preventionofcomplications:preventionof

intestinal

adhesion,fluidinfusiontopreventbleeding,infection,etc.3.Postoperative

NursingInterventionSurgicalTherapy

第三十九頁，共52頁

Activity:Passiveactivity3.Postoperative

NursingInterventionSurgicalTherapy

第四十頁，共52頁Health

Guidance

fordischargedpatientsAnimportantwaytopreventintussusceptionandfinddiseasesintime.第四十一頁，共52頁*Livingguide*Diseaseobservation*Dietguide*Specialcareguide第四十二頁，共52頁LivingGuide*Lettheparentsrealizethe

importanceofkeepmoving.*Enoughphysicalactivities.*Preventionofintestinal

adhesion.EXERCISE第四十三頁，共52頁INFECTIONPREVENTIONAdenovirusinfectionIntestinallymophfollicleshyperplasiaExcessiveintestinalStimulatetheautonomicnervoussystemperistalsisIntussusceptionSo*Preventcolds*SafetyfoodLivingGuide第四十四頁，共52頁DiseaseObservationWOUNDNURSING*Takeashowerinsteadofbath.*Getridoftheriskfactorsof

damagingthewound.*Ifthewoundisredor

cracks,pleasegotohospital.第四十五頁，共52頁DiseaseObservationPainnursingAttentions!Ifthechildcrieswithanyparoxysmal,youhadbetterdoatimelymannerBtoexceedcheek,againsttoruleoutthepossibilityofintussucception.pain3-10monthshealthyfatinfant*colickyabdominalpain

*abdominal

swelling

or