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Pediatric inguinal hernia nursing science

Pediatric surgery   Zeng Jie

Parents often go to the emergency department of pediatric surgery late at night and hurry to hug the baby to see the doctor: "Doctor, doctor, my baby has a big bag at the base of the thigh, what should I do?" The doctor looked at it and it turned out to be indirect inguinal hernia in children. As a parent and friend, how much do you know about indirect inguinal hernia in children?

1. What is indirect inguinal hernia in children?

It refers to a mass formed by abdominal viscera bulging through a weak point on the abdominal wall, usually caused by excessive force. Such as: crying hard, coughing, urinating hard or defecating, it will cause the pressure in the abdominal cavity to increase, and the internal structure of the abdominal wall will fall into the groin or scrotum through the weak abdominal wall to form an increasingly large mass. Just like a tire, when the outer tire is damaged, the inner tube will bulge from the damaged part, and the originally flat tread bulges up a bag.

two, What are the clinical manifestations of indirect inguinal hernia ?

休息后可消退,是典型表现。 Infants and children coughing vigorously and vigorously moving, the groin or scrotum bulged more obvious mass, which can subside after lying down or resting, is a typical performance. 孩发病率好发于女孩 The incidence of boys is more common in girls . The doctor will advise parents to choose conservative treatment or surgical treatment according to the child's condition.

three, What needs surgery?

6 个月以上 可以安排择期手术。 In general, after the diagnosis of indirect inguinal hernia in children is clear, if the baby does not have symptoms such as a cold, elective surgery can be arranged for more than 6 months .

Except for a few special cases, surgical treatment should be performed as soon as possible. Incarceration of an inguinal hernia can cause intestinal necrosis and damage to the reproductive system, and even life-threatening. Because this is the most dangerous complication, the younger the age, the higher the incidence of incarceration.

4. If your baby is scheduled for surgery, what are the precautions for nursing?

术前请您注意: (1) Please note before operation:

、尽量避免腹内压增高的因素,保持大便通畅,防剧烈哭闹,注意冷暖及饮食卫生,避免咳嗽及腹泻,剧烈哭闹时可抬高臀部,或用手轻压腹股沟肿块处,防止斜疝嵌顿。 1. Try to avoid the factors of increased intra-abdominal pressure, keep the stool unobstructed, prevent severe crying, pay attention to cold and warm and diet hygiene, avoid coughing and diarrhea, raise the hips during severe crying, or gently press the groin mass to prevent oblique Hernia incarcerated.

、如患儿腹股沟肿块不能自行回纳,患儿哭闹明显、呕吐、阴囊红肿、疼痛、发紫应及时告知医护人员。 2. If the child's groin mass cannot be recovered on his own, the child should be notified of crying, vomiting, scrotal redness, pain, and purpleness.

术后请您注意: (2) Please note after the operation:

、麻醉未清醒前,应去枕平卧 4-6 小时,头偏向一侧,防止呕吐引起窒息。 1. Before the anesthesia is not awake, you should go to the pillow for 4-6 hours and lie on your head with your head tilted to one side to prevent vomiting and suffocation. At the same time, it is necessary to observe the complexion and breathing situation. If there is any abnormality, call the medical staff in time.

、饮食:麻醉清醒后 6 小时按医嘱进食,可先进少量白开水或流质饮食,注意饮食卫生、少量多餐进食,以后根据医嘱逐步给予半流质、幼儿饮食;适当增加营养,给易消化饮食,如稀饭、烂面条、肉末、动物肝脏、鱼、蛋、新鲜水果蔬菜等,少吃难以消化、易胀气的食物,如糯米饭、年糕、玉米、花生、韭菜、芹菜等。 2. Diet: 6 hours after anesthesia , you can eat according to the doctor's instructions. You can use a small amount of plain water or liquid diet. Pay attention to diet hygiene and eat a small number of meals. Afterwards, you should gradually give semi-liquid and infant diets according to the doctor's instructions; Such as porridge, rotten noodles, minced meat, animal liver, fish, eggs, fresh fruits and vegetables, etc., eat less digestible and easily flatulent foods, such as glutinous rice, rice cakes, corn, peanuts, leeks, celery, etc.

、伤口护理:保持患儿伤口敷料清洁、干燥、避免大小便污染。 3. Wound care: keep wound dressings clean and dry in children, and avoid contamination of urine. Pay attention to whether there is blood or fluid in the wound. The baby's hands should be covered with clean socks. When the wound is itchy, do not grab it with your hands to prevent the wound from becoming inflamed and split.

(3) Matters needing attention after discharge :

、避免患儿剧烈哭吵及活动,防止腹内压增高,保持伤口敷料清洁干燥。 1. Avoid violent crying and activities of children, prevent the increase of intra-abdominal pressure, and keep the wound dressing clean and dry.

、注意观察腹股沟、阴囊红肿消退情况,观察腹股沟有无肿物突出。 2. Pay attention to the resolution of the groin and scrotum redness and swelling, and observe whether the groin is protruding. If the redness and swelling have not resolved or are abnormal for a long time, the wound is red, swollen, and painful.

0797-8282002 Tel of pediatric surgery follow- up: 0797-8282002 . I wish the baby a speedy recovery!