ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (9): 1115-1118.doi: 10.3761/j.issn.2096-7446.2026.09.015

• 重症护理研究 • 上一篇    下一篇

早产儿消化道畸形伴喉软化行气管切开的分期救治护理

施凤双1(), 陈丽骊1, 李柳青1, 魏梦荻1, 诸纪华2,*()   

  1. 1 儿童少年健康与疾病国家临床医学研究中心/浙江大学医学院附属儿童医院胸外科 杭州市 310052
    2 儿童少年健康与疾病国家临床医学研究中心/浙江大学医学院附属儿童医院护理部 杭州市 310052
  • 收稿日期:2025-11-18 出版日期:2026-09-10 发布日期:2026-08-31
  • 通讯作者: 诸纪华，E-mail：jihuazhu@zju.edu.cn
  • 作者简介:施凤双：女，本科，主管护师，副护士长，E-mail：6508034@zju.edu.cn
    作者贡献声明

    施凤双：论文撰写及修改；陈丽骊、李柳青、魏梦荻：资料收集、文献检索；诸纪华：论文指导

  • 基金资助:
    浙江省教育厅一般科研项目(Y202353945)

Nursing care of staged treatment for a premature infant with gastrointestinal malformation and congenital laryngomalacia undergoing tracheotomy

SHI Fengshuang1(), CHEN Lili1, LI Liuqing1, WEI Mengdi1, ZHU Jihua2,*()   

  1. 1 National Clinical Medical Research Center for Children and Adolescents’ Health and Diseases/Department of Thoracic Surgery， Children’s Hospital Zhejiang University School of Medicine， Hangzhou 310052， China
    2 National Clinical Medical Research Center for Children and Adolescents’ Health and Diseases/Department of Nursing， Children’s Hospital Zhejiang University School of Medicine， Hangzhou 310052， China
  • Received:2025-11-18 Online:2026-09-10 Published:2026-08-31
  • Contact: * ZHU Jihua，E-mail：jihuazhu@zju.edu.cn
  • Supported by:
    Zhejiang Provincial Education Department General Research Project(Y202353945)

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摘要：

总结1例消化道畸形早产儿伴喉软化行气管切开及分期手术的护理体会。针对患儿早产低体重、多阶段手术且合并气管切开等护理难点，采取以循证为基础的围手术期全程管理策略：术前做好呼吸道管理与误吸预防；术后实施精细化气道管理与气管切开护理；落实十二指肠吻合与胃造瘘术后胃肠功能重建护理；优化内应力延长术的护理配合；改良支撑胃管防滑脱护理；给予序贯式营养支持与动态喂养管理。经过147 d精心治疗与护理，患儿胃肠功能恢复良好，病情稳定后转康复科治疗。

关键词: VACTERL综合征, 先天性喉软骨软化, 婴儿, 早产, 气管切开术, 围手术期护理

Abstract:

To summarize the nursing experience of a premature infant with gastrointestinal malformation and congenital laryngomalacia who underwent tracheotomy and staged surgeries. In response to key nursing challenges including prematurity and low birth weight，staged surgeries and tracheotomy，an evidence-based perioperative comprehensive management strategy was implemented，including preoperative prevention of aspiration，postoperative refined airway management and tracheotomy care，precise nursing care for gastrointestinal function reconstruction after duodenal anastomosis and gastrostom，optimization of nursing cooperation during internal traction elongation and risk prevention of the supporting gastric tube，sequential nutritional support and dynamic feeding management. After 147 days of meticulous treatment and nursing，the infant’s gastrointestinal function recovered well，and the patient was transferred to the rehabilitation department in stable condition.

Key words: VACTERL, Congenital Laryngomalacia, Infant, Premature, Tracheotomy, Perioperative Nursing