Abstract: Objective To explore a more suitable method for preoperative family rectal irrigation care for neonates with Hirschsprung's disease （HSCR）. Methods A randomized block design method was used to divide 100 neonates with HSCR who were <3 months old into 50 cases each in the routine group and the intervention group. Parents in the routine group received regular rectal irrigation guidance. Parents in the intervention group receive guidance of implementing rectal irrigation according to the indicators of good practice of family rectal irrigation. Tailored family rectal irrigation was performed to their child. The incidences of abdominal distension, abdominal drum sound, stool traits, enterocolitis, and intestinal perforation were compared between the two groups before and after intervention. The chi-square test was used to compare the results of the two groups. Results There were no significant differences in neonates' age, diagnosis of HSCR and parental education level between the two groups. There were 15 cases and 4 cases in the abdomen with drum sounds in the routine and intervention group respectively, χ²=6.50, P=0.01. Stool color was not fresh with stench odor was shown in 8 cases in the routine group and 1 in the intervention group respectively, χ²=4.40, P=0.03. There were no enterocolitis, intestinal perforation or decreased milk intake after family rectal irrigation in both groups. Conclusion Tailored family rectal irrigation care for neonates with HSCR is recommended as a new standard of guidance for family rectal irrigation care. It is safe and effective, and is easily accepted by parents who do not have medical expertise. It can be used in families with HSCR neonates.

Key words: guidance, neonates, family, Hirschsprung's disease （HSCR）, rectal irrigation

摘要： 目的 探讨更适用于新生儿先天性巨结肠症（HSCR）患儿术前家庭通便护理指导方法。方法 采用随机区组设计法将100例年龄<3个月的HSCR患儿分常规组和改良组各50例,常规组对家长进行常规灌肠指导,改良组指导家长根据家庭通便护理合格指征为患儿进行个性化家庭通便,比较干预前后两组患者腹胀、腹部鼓音、大便性状、小肠结肠炎、肠穿孔发生例数,采用卡方检验比较两组结果有无差异。结果 两组患儿年龄、诊断及家长文化水平无统计学差异。腹部有鼓音常规组及改良组分别为15例、4例,χ²=6.50,P=0.01。大便颜色陈旧、气味异常者常规组8例、改良组1例,χ²=4.40,P=0.03。两组患儿均无并发小肠结肠炎、肠穿孔或灌肠后吃奶量下降等拒奶表现。结论 以家庭通便护理合格指征为标准指导新生儿HSCR患儿家长进行个性化家庭通便护理,安全有效,易于被不具备医学专业知识的家长接受,可用于新生儿HSCR患儿家庭的家庭通便护理指导。

关键词: 指导, 灌肠, 先天性巨结肠症, 新生儿, 家庭