POSTOPERATIVE NURSING OF CONGENITAL ANAL ATRESIA
REN ZM
Children’s Hosptal,
Chongqing University of Medical Sciences, Chongqing, China
Objective: To explore the mainpoint of postoperative of
anoplasty and improve the living quality of the patients.
Methods: 108 patients with anal atresia had been treated from
January 1993 to December 2000, including 87 boys and 21 girls whose ages
were from 1 day to 2 years old. Of all cases, 38 cases were high anal
atresia and 70 cases were low. 70 patients were performed by perineal
anoplasty, 32 patients by Pena’s operation, and 6 patients by
abdominoperineal anoplasty. Before the recovery from anesthesia, the
monitoring and the nursing of patients were very important. Neonates were
usually kept body warm on the radiate platform and used antibiotics to
prevent from neonatal scleroedema and pneumonia. Anus should be washed with
neogeramine to keep it clean, then local wounds were sprayed with Amikacin
Liquor and exposured with TDP twice every day. The post-hospital rehabilitation
instructions should be paid much attention to. A rigid plan for enlarging
anus should be made and practiced two weeks after operation. Enlarging anus
was performed 2-3 times per day during the first two months, one time per
day during the next two months, one time every 2-3 days during the third
two months, and one time every 3-5 days during the last half year to two
years. moreover, the time for enlarging anus should last for 10-15 minutes
each time, and the course must be completed.
Results: 108 patients were in hospital for 10 –19 days, and
average was 13.5±0.8
days. All patients recovered from the illness. In the 56 patients who were
follow-up for 16 to 36 months, 50 patients could defecate normally and 4
patients with cicatricial contracture were recovered finally after
enlarging anus repeatedly. However, 2 patients were encopresis. Conclusion: The careful
postoperative care and detailed post-hospital rehabilitation instructions
are vital for the recovery of anal atresia.