AimWe aimed to investigate the short-term efficacy and safety of laparoscopic pyeloplasty for treating newborns with severe hydronephrosis due to ureteropelvic junction obstruction (UPJO).MethodsA retrospective analysis was performed on 16 newborn patients with severe neonatal hydronephrosis who underwent laparoscopic pyeloplasty at our hospital from January 2021 to November 2022. All patients were regularly followed up. Laparoscopic pyeloplasty with double J stent placement was performed after the presence of severe hydronephrosis was confirmed.ResultsAmong the 16 pediatric patients (13 males, 3 females), the left side was affected in 13 cases and the right side in 3. The average age at surgery was 9.50 (8.50–12.00) days, with an average weight of 3.30 ± 0.95 kg. Laparoscopic pyeloplasty was performed in all cases without the need for open conversion. The mean surgery duration was 292.06 ± 73.60 min, with minimal blood loss (2.50, 2.00–5.00 ml). Postoperative hospital stays averaged 13.44 ± 4.70 days. No anastomotic leakage occurred, and follow-ups at 1, 3, 6, and 12 months showed no stent displacement, except for one case where the stent was removed at 1 month, and the others at 3 months. There were no cases of worsened hydronephrosis, except for one with renal atrophy at the 6-month follow-up. Changes in renal pelvis anteroposterior diameter exhibited a time effect (F = 49.281, P < 0.001), with significant differences at 1, 3, 6, and 12 months postoperatively compared to preoperative values (P < 0.05). Notably, differences were observed between 6 and 3 months, as well as between 12 and 3 months postoperatively (P < 0.05). Similarly, renal parenchymal thickness changes showed a time effect Pediatric urology, Guangdong Women and Children Hospital, Guangzhou, China (F = 49.281, P < 0.001), with significant differences at 1, 3, 6, and 12 months postoperatively compared to preoperative values (P < 0.05). Significant differences were also noted between 6 and 1 month, as well as between 12 and 1 month postoperatively (P < 0.05). There was one case of urinary tract infection after surgery, and no case of recurrence was observed.ConclusionSevere neonatal hydronephrosis must be treated promptly. Laparoscopic pyeloplasty is a safe and feasible treatment with minimal complications for newborn patients with severe hydronephrosis due to UPJO.

ObjectiveThe treatment timing of ureteropelvic junction obstruction (UPJO) in infants remains controversial. This study aimed to compare the recovery effect of renal morphology of immediate and delayed laparoscopic pyeloplasty in infants with severe UPJO.MethodsThe infants with severe UPJO-induced hydronephrosis who underwent laparoscopic pyeloplasty according to their age at the time of surgery [the immediate treatment (IT) group: ≤1 month of birth, the delayed treatment (LT) group: 3–6 months of birth] in our center between 2010 and 2019 were enrolled in this study. Ultrasonography was used to assess renal morphology, including anteroposterior diameter (APD) of a pelvic, parenchymal thickness (PT), polar length (PL), and Society of Fetal Urology (SFU) grade. Preoperative and postoperative renal morphological outcomes at 6, 12, and 24 months were measured and compared.ResultsDuring this period, a total of 135 patients were assigned to receive either IT (n = 73) or LT (n = 62) and were included for analysis. There were no significant differences in renal morphology indices at baseline between groups of IT and LT. The APD, PT, and PL in both groups all recovered to certain degrees compared with those at baseline, however, the IT group recovered more significantly than the LT group. Despite there being no significant difference in SFU grade between the two groups before and after surgery, the reduction of SFU grade in the IT group was more significant than that in the LT group during the 6-, 12- and 24-month follow-up periods. The PL, SFU, and APD were greater in the IT group than in the LT group at 6, 12, and 24 months of follow-up. At 6 months PL was not significantly higher between the two groups, while the outcome was significantly different at 12 months and 24 months.ConclusionImmediate laparoscopic pyeloplasty for the infant with severe ureteropelvic junction obstruction is effective, and it can accelerate the recovery of renal morphological indices in infants with severe UPJO-induced hydronephrosis.

目的 探讨健康教育在子宫肌瘤患者桂枝茯苓方联合高强度聚焦超声(HIFU)治疗中的应用.方法 选取2019年1月～2020年1月我院收治的子宫肌瘤桂枝茯苓方联合HIFU治疗患者82例,采用随机数字表法将其分为两组,对照组进行常规护理,研究组在对照组的条件上进行健康教育,比较两组患者依从性、并发症发生率及满意率.结果 研究组依从性高于对照组(P<0.05);研究组并发症发生率低于对照组(P<0.05);研究组满意率高于对照组(P<0.05).结论 子宫肌瘤患者桂枝茯苓方联合HIFU治疗中,使用健康教育后的效果明显提高,值得临床使用.

目的 探讨个体化护理干预在先天性肺囊腺瘤患儿经胸腔镜肺叶切除术围手术期的应用效果.方法 将62例经胸腔镜手术的先天性肺囊腺瘤患儿,采用完全随机设计分为常规护理对照组和个体化护理观察组,比较两组患儿住院时长、围手术期不良事件发生率、术后并发症发生率及护理满意度.结果观察组患儿住院时间为(7.48±1.37)d,少于对照组的(8.32±1.56)d,围手术期不良事件发生率及术后并发症发生率均为6.5％,分别小于对照组的22.5％和19.3％,护理满意率为90.3％,高于对照组的77.4％.结论 对经胸腔镜手术的先天性肺囊腺瘤患儿进行个体化护理干预,能够缩短住院时间,降低不良事件和并发症发生率,提高护理满意度,值得临床推广应用.

目的:探讨医护一体化管理模式在小儿化脓性中耳炎治疗护理中的应用效果。方法:选取2016年5月至2018年4月该院治疗的96例小儿急性化脓性中耳炎患儿。根据随机数字表法将患儿分为干预组(50例)和对照组(46例)。对照组实施常规护理管理模式，干预组在对照组基础上给予医护一体化管理模式干预。观察两组患儿临床疗效和干预前后听力障碍恢复情况，分析并比较两组患儿家属护理满意度及并发症发生情况。结果:干预组临床治疗总有效率明显高于对照组，差异有统计学意义( P<0.05)；与干预前相比，干预后两组患儿的听力障碍分值均下降，且干预组低于对照组，差异有统计学意义( P<0.05)；在护理满意度方面干预组家属护理总满意率明显高于对照组，差异有统计学意义( P<0.05)；干预组并发症总发生率明显低于对照组，差异有统计学意义( P<0.05)。 结论:医护一体化管理模式可改善小儿急性化脓性中耳炎患儿的临床治疗效果，提高患儿家属护理满意度，减少并发症发生率，值得临床推广。

Objective:To explore the effect of quality control circle (QCC) activity in reducing wound pain after hypospadias surgery.Methods:24 cases of hypospadias undergoing urethroplasty did not receive QCC management from March to June 2018, 29 cases of hypospadias undergoing urethroplasty received QCC management from July to October 2018. The pain rate, the satisfaction of the children and their families of the two groups were compared.Results:Tangible effect: postoperative wound pain rate decreased from 137.5% before QCC activity to 48.3% after QCC activity ( P<0.05), the effect was obvious. Intangible effect: the sense of responsibility had been significantly improved to provide better care for children and their families, improved the satisfaction of children and their families, the satisfaction of children and their families increased from 75.0% to 93.1%. Conclusion:Correct application of QCC to carry out effective intervention on wound pain after hypospadias surgery, can reduce the rate of wound pain after hypospadias surgery, provide better care for the children, and improve the satisfaction of children and their families.

Objective:To summarize the clinical characteristics of fetal congenital diaphragmatic hernia (FCDH) at a single center so as to explore the outcomes of integrated mode of fetal diagnosis and postnatal treatment for FCDH.Methods:Clinical data of 258 hospitalized FCDH children from January 2013 to October 2017 were retrospectively analyzed. Thirty-five cases were chosen for termination of pregnancy (TOP). Among the remaining 223 CDH cases, there were 143 boys and 80 girls with an average prenatal diagnostic gestational age of (25.4±6.2) weeks, an average birth gestational age of (38.8±4.3) weeks and an average birth weight of (3.25±0.53) kg. The involved side was left ( n=206), right ( n=51) and bilateral ( n=1). Nineteen cases were associated with other malformations. Prenatal ultrasonic severity was mild ( n=141), moderate ( n=62) and severe ( n=55). Results:The outcomes were curative ( n=184) and death ( n=39). The survival rate rose to 81.8% in 2017 from 57.7% in 2014; the rate of mini-invasive surgery from 0% in 2014 spiked to 95.6% in 2017, the recurrence rate of mini-invasive surgery decreased from 20% in 2015 to 6.15% in 2017. Among 39 deaths, 31 cases (79.5%) had severe pulmonary hypertension (24 postnatal cases non-responding after aggressive treatment, including 5 lethal surgical cases per family requests, 5 cases with postoperative pleural effusion and 2 cases with postoperative pneumothorax), 4 cases (10.3%) had severe postnatal asphyxia, 2 cases (5.1%) had lower blood blockage after surgery, 1 case (3.2%) with unilateral complete diaphragm defect gave up treatment and 1 case (3.2%) gave up treatment after twice recurrence. Conclusions:Integrated mode of prenatal diagnosis and postnatal treatment is an effective management mode for managing CDH. It may boost the survival rate for mild CDH and reduce the mortality for moderate/severe CDH.

目的:报道1例早产儿肘部贵要静脉留置针穿刺误入肱动脉,导致肱动脉痉挛的护理经验.方法:护理要点包括轻柔按摩、湿热敷、改变体位、袋鼠式护理、保暖、非营养性吮吸、病情观察等,以减少不良刺激,缓解动脉痉挛,尽快恢复血液循环.结果:经过及时处理,15 min后穿刺侧肢体恢复正常,活动自如.结论:静脉穿刺误入动脉引起的动脉痉挛多数是可逆的,及时予以处理对快速恢复血液循环,避免产生不良后果十分重要.

目的 探讨预见性护理联合放松疗法在患儿耳道冲洗中的应用效果.方法 选取2016年1月至2018年1月在我院行耳道冲洗治疗的患儿120例为研究对象,按随机数字表法将其等分为观察组和对照组.两组患儿均采用相同的冲洗方法,对照组给予常规护理,观察组给予预见性护理联合放松疗法干预.比较两组患儿一次冲洗成功率、不良反应发生率.结果 观察组一次冲洗成功率高于对照组,差异有统计学意义(P<0.05).观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05).结论 预见性护理联合放松疗法可提高患儿耳道冲洗一次成功率,降低不良反应发生率,临床应用效果好,可推广应用.

Objective To discuss the application and nursing key points of neonatal bilateral congenital choanal atresia (CCA) plasty under the treatment of improved ring-shaped nasopharyngeal tube.Methods Retrospectively analyzed clinical data of 18 neonates with bilateral CCA in otorhinolaryngology department of our hospital from August 1,2013 to December 31,2017,summarized the application and nursing key points of improved ring-shaped nasopharyngeal tube.Results In this group,1 case had choanal stenosis when pulling out the catheter 1 month after operation,posterior margin of the nose in 2 cases were wounded and leaded to cicatricial stenosis because of the silk thread broken 5 months after operation,all of them had bony atresia and underwent re-operated correcting.The other 15 children recovered well when pulling out the catheter within 3 to 6 months after operation.All children had no tube plugging.Conclusion The dilatation treatment of improved ringshaped nasopharyngeal tube can avoid the catheter coming off,which can be completely eradicated by wearing fingerless gloves,postoperative nursing and discharge guidance are the key points to prevent the catheter coming off and plugging.

目的:总结1例小儿肾上腺皮质癌的围手术期护理.方法:术前通过监测血压,降压、心理护理、常规术前准备等确保患儿手术顺利进行,术后通过严密监测患儿生命体征特别是血压、心率,预防肾上腺危象的发生、伤口及管路护理等减少并发症的发生.结果:患儿顺利出院,病理结果出来后转外院行化疗.结论:小儿肾上腺皮质癌术后护理对患者病情恢复意义重大.

Objective To discuss the perioperative nursing for pediatric percutaneous nephrostomy guided by B ultrasound.Method Retrospectively analyzed the perioperative nursing of 49 children undergoing percutaneous nephrostomy in 2015,including preoperative nursing,intraoperative cooperation,postoperative nursing,and health education.Results Among the 49 patients,postoperative effect of 44 patients were good,without complications;4 patients had postoperative urinary infection;1 patient had unplanned extubation of drainage tube;the incidence of complications was 10％.Conclusions Pediatric percutaneous nephrostomy guided by B ultrasound is effective for postoperative recovery in pediatric patients with severe hydronephrosis.Positive and effective nursing is important in improving operation success rate and decreasing postoperative complications.

Objective To explore the effect of the application of evidence-based nursing care in postoperative pain management in children with pulmonary sequestration.Method 105 participants were divided into a control group (n=52) and an intervention group (n=53) by random number table.The control group was routinely cared;in addition,the intervention group was given evidence-based nursing care.The pain scores on the surgery day and the first day after surgery and the family members' satisfaction scores were collected.Results On the surgery day and the first day after surgery,the pain scores were (4.36±0.79) and (2.28±0.72) in the intervention group,which were significantly lower than those in the control group [(5.12±0.88) and (2.83±0.76)].The family members' satisfaction was 98.11％ in the intervention group and was 71.15％ in the control group,with a statistical difference (P ＜ 0.05).Conclusions Evidence-based nursing care can effectively alleviate postoperative pain in children with pulmonary sequestration and satisfy the family members,so it is worth being clinically generalized.

目的 比较改良尿管固定法及常规尿管固定法在小儿阴茎术后留置尿管管理中的应用效果.方法 把小儿泌尿外科120例阴茎术后留置尿管的患儿随机分为改良尿管固定组及常规尿管固定组,每组60例,采用两种不同的固定方法 ,从两组患儿在尿管固定牢固性、意外拔管率两方面进行分析比较.结果 两种尿管固定方法 在尿管固定牢固性、意外拔管率均存在明显差异性.结论 改良尿管固定法在小儿阴茎术后留置尿管管理中优于常规尿管固定法,可以增加尿管固定牢固性,减少尿管胶带更换频率,减少护士工作量,并可减少意外拔管率.

Objective To evaluate the effect of Xingqi Tongfu Pad on the intestinal functions of children with acute abdomen after surgery. Methods The random digit table was used to randomize 146 patients with acute abdomen into treatment group (n=71) and control group (n=75) according to their registration number. In the control group, the patients only received normal treatment and nursing, while those in the treatment group received Xingqi Tongfu Pad for the acupoint application in addition to routine treatments. The two groups were compared in terms of the time of bowel sound recovery , the exhaust defecation time and gastrointestinal dysfunction score. Results The bowel sounds and the first exhaust and defecation in the treatment group appeared obviously earlier than those in the control group . The score on gastrointestinal dysfunction in the treated group was significantly higher than that of the control group (P<0.05). Conclusions Xingqi Tongfu Pad can promote the recovery of gastrointestinal function after abdominal operation. It deserves popularization for its positive effect, cheap price and easy operation.

Through utilizing electronic nursing records, designing new modules, a nursing administrative group and a information engineer cooperated to establish a information system to managing nursing quality indicator. With its function of inputting, searching and computing data, the system effectively improved the integrity, flexibility, timeliness of data, which provided a foundation for the hospital to make scientific decisions based on facts.

目的:以先天性膈疝的临床实际治疗为基础来充分了解此病并且创新治疗方法。方法:集中分析22位患有先天性膈疝的患儿的临床资料。结果:在22例病例中有13例重症,剩余9例症状较轻。在患儿住院之后,禁止进食任何食物来减轻肠道系统负担,对于症状较重者,应及时插入呼吸管进行人工通气;症状较轻者在24小时内紧急进行手术处理。13例重症患儿的病情得到稳定之后,安排5例患儿在24小时内进行急诊经腹膈疝修补术,剩余的患儿将手术规格降低为亚急诊。在所有的22例患儿中,经手术后死亡的有1例,放弃治疗出院有2例,剩余的均治愈出院,术后随访7个月至2年,恢复良好。结论:在手术之前使用相关手段改善心肺功能,可以延后手术时间,使患有先天性膈疝的新生儿生存几率更大。

目的总结先天性肺囊腺瘤患儿的诊断和手术治疗方法。方法回顾性分析36例先天性肺囊腺瘤的患儿CT扫描检查、X线胸片检查和手术治疗结果。结果Ⅰ型20例,Ⅱ型11例,Ⅲ型5例。单侧病变24例(左叶14例,右叶10例),双侧病变12例。36例先天性肺囊腺瘤患儿采用开胸手术进行治疗,经治疗后进行7～24个月的随访,本组患儿全部生存,且无术后复发现象。结论影像学诊断对于先天性肺囊腺瘤的诊断不失为一种好的方法。对于确有病变者,外科手术切除是一种有效的方法。

Objective To investigate the quality of life(QOL) after operation in breast cancer patients and analyze its influential factors.Methods Using Functional Assessment of Cancer Therapy-Breast(FACT-B),the condition of 155 patients with breast cancer at 3 months,6 months,1 year,2 years,3 years,and 5 years after operation was assessed,including five dimensions:physical well-being,social/family well-being,emotional well-being,functional well-being and additional concerns.The influential factors on quality of life including age,education,marital status,mode of payment,pathological stage,and postoperative time as variables were processed for analysis of variance.QOL scores were used as dependent variables,the variables with P<0.05 in analysis of variance(age,staging,postoperative time) as the independent variables for multiple linear regression analysis.Results Analysis of variance showed that QOL scores had statistical difference in different age,pathological stage,and postoperative time(P<0.050).Multiple linear regression analysis showed early stage breast cancer patients had higher QOL score than intermediate stage patients did,and QOL score at postoperative 12 months,60 months was significantly higher than that at postoperative 3 months(P<0.05).Conclusion Pathological stage and postoperative time are influential factors of QOL.Accordingly,the effective interventions such as extensive breast cancer screening,functional exercises and psychological counseling should be given in order to promote the QOL of patients.

目的:探讨唇腭裂新生儿术前矫治方法与技术及术后结局.方法:选择我院2011年2月至2012年2月收治的单侧唇腭裂患儿12例,采用鼻腭矫治器(PNAM)行术前矫治(观察组),并就临床资料与不行术前矫治的12例同类型疾病的患儿(对照组)行回顾性分析.结果:观察组矫治后患儿鼻小柱歪斜度、双侧鼻翼高度差、腭部裂隙最大处、牙槽突裂间距、唇部软组织间距均明显改善,优于矫正前(P＜0.05).观察组鼻翼高度之差、鼻小柱歪斜度之差情况明显好于对照组(P＜0.05).结论:唇腭裂新生儿开展术前矫治,为手术的开展创造了条件,具有积极的应用价值.