探讨先天性巨结肠患儿围手术期护理难点，制定护理策略，确保护理效果，减少术后并发症的发生。

选择2007年1月至2013年6月于江苏省南通瑞慈儿童医院接受经肛门改良Soave Ⅰ期拖出根治成形术治疗的39例先天性巨结肠患儿为研究对象。对其手术前、后临床特征进行评估，护理策略包括心理疏导、营养支持、肠道准备、术后肛周护理及排便功能训练(本研究遵循的程序符合江苏省南通瑞慈儿童医院人体试验委员会制定的伦理学标准，得到该委员会批准，征得受试对象监护人的知情同意，并与其签署临床研究知情同意书)。

对本组患儿实施相关护理策略后，体质量在出院时均较入院时明显增加，平均增加(1.1±0.21)kg。术后无一例患儿发生出血、感染及肛门狭窄等并发症，并且无护理相关并发症发生。随诊期间，根据Heikkinen评分标准，其排便功能优良率为89.7%。

根据先天性巨结肠围手术期的护理难点对患儿制定、实施有效护理策略，可降低该病患儿术后并发症发生率，提高患儿生活质量、促进康复。

To explore difficulties of nursing care with congenital megacolon in peri-operation and make appropriate countermeasures in order to ensure the nursing effectiveness.

From January 2007 to June 2013, a total of 39 cases of children with congenital megacolon were suffered from modified Soave Ⅰ surgery. Preoperatively and postoperatively clinical signs of these cases were estimated. Nursing strategies were included psychological and nutritional support, intestinal preparation, postoperative nursing of ass and training of defecation.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Rich Children's Hospital.Informed consent was obtained from the parents of each participating child.

To put with correct nursing strategies, body weight of each participating child was significantly increased at the time of discharge, the average increased value was (1.1±0.21) kg.There had no complications (including blooding, infection, anastomotic stenosis) occurred and no nursing related complications occurred. During follow-up, according to the Heikkinen score standard, the excellent and good rates of their defecation function were 89.7%.

According to the nursing difficulties of perioperation to children with congenital megacolon, to put with effective nursing strategies play an important role in reducing the incidence of preoperatively and postoperatively complications in children with congenital megacolon, improving their quality of life, and promoting their rehabilitation.