造痿袋、持续冲洗联合伤口保护罩对急性重症胰腺炎术后的护理效果

摘要

目的探讨造瘘袋辅助护理、持续冲洗联合伤口保护罩对急性重症胰腺炎患者的干预效果。方法以我院2013年2月至2015年2月收治的65例急性重症胰腺炎手术患者为研究对象，依据不同护理方法将患者分为观察组与对照组，观察组行造瘘袋辅助护理、持续冲洗及伤口保护罩等综合干预，对照组采取常规护理，比较两组护理效果、肠瘘发生率及患者满意度评分。结果观察组日均换药次数、日常更换床单次数、伤口缩小30%所需时间分别为(2.4±0.7)次、(1.4±0.5)次、(20.2±5.6)d，均显著少于对照组的(8.3±3.6)次、(5.5±1.7)次、(34.4±8.5)d，差异有统计学意义(P<0.05)。观察组肠瘘、继发感染、住院期死亡发生率分别为2.5%、5.0%、7.5%，均显著低于对照组的16.0%、24.0%、28.0%(P<0.05)。观察组干预后身体舒适度、切口舒适度、安全感及情绪评分均明显高于对照组(P<0.05)。结论造瘘袋辅助、持续冲洗联合伤口保护罩综合护理干预能明显降低肠瘘发生率，显著减少患者死亡人数，同时能明显减轻护士工作量，提高患者满意度。%Objective T o explore the intervention effects of ostomy bag aided nursing, continuous irriga-tion combined with wound protective cover in patients with severe acute pancreatitis. Methods Sixty-five pa-tients who underwent operation for severe acute pancreatitis in our hospital, between February 2013 and February 2015, were included in the study. According t o the different nursing methods, patients were divided into the observation group and the control group. The observation group was given comprehensive nursing, such as ostomy bag aided nursing, continuous irrigation and wound protective cover, while the control group was given routine nursing. The nursing effects, incidence of intestinal fistula and patients’satisfaction scores were compared between two groups. Results The average daily frequency of dressing change, times of daily sheet change and the time required to reduce 30%of the wound in the observation group were significantly less than that in the control group (2.4±0.7 vs. 8.3±3.6 times;1.4±0.5 vs. 5.5±1.7 times;4.4±8.5 vs. 20.2±5.6 d) (P< 0.05), respectively. The incidence of intestinal fistula, secondary infection and in-hospital mortality (2.5%, 5.0%, 7.5%) in the observation group were significantly lower than those in the control group (16.0%, 24.0%, 28.0%) (P<0.05). After intervention, the scores of physical comfort, incision comfort, sense of safety and emotion in the observation group were significantly higher than those in the control group (P< 0.05). Conclusion Comprehensive nursing intervention including ostomy bag aided nursing, continuous irrigation and wound protective cover could reduce the incidence of intestinal fistula and the mortality. Besides, it could sig-nificantly reduce the workload of the nurses and improve the satisfaction of the patients.