中华护理杂志 ›› 2024, Vol. 59 ›› Issue (14): 1757-1760.DOI: 10.3761/j.issn.0254-1769.2024.14.014

• 疑难病例护理 • 上一篇    下一篇

1例急性肠系膜静脉栓塞患者行节段性小肠切除的护理

朱慧娣(), 章梅云(), 江月红, 徐巧英, 陈叶红   

  1. 310013 杭州市 浙江大学医学院附属第一医院护理部(朱慧娣,章梅云),胃肠外科(江月红,徐巧英,陈叶红)
  • 收稿日期:2023-09-13 出版日期:2024-07-20 发布日期:2024-07-11
  • 通讯作者: 章梅云,E-mail:23472347@zju.edu.cn
  • 作者简介:朱慧娣:女,本科,副主任护师,护士长,E-mail:hzzhuhuidi0505@yeah.net

Nursing care after segmental small bowel resection in a patient with acute mesenteric vein embolism: a case report

ZHU Huidi(), ZHANG Meiyun(), JIANG Yuehong, XU Qiaoying, CHEN Yehong   

  • Received:2023-09-13 Online:2024-07-20 Published:2024-07-11

摘要:

总结1例急性肠系膜静脉栓塞患者行节段性小肠切除的护理经验。护理要点:早期识别保留肠管的坏死征象,积极改善其组织灌注,防止肠管坏死;基于协同护理模式,对4个肠造口进行接力式的肠内营养支持;手术切口和肠造口联合换药,控制手术切口感染和肠造口周围皮炎;关注患者和家属的心理,提供心理支持。患者术后42 d顺利进行肠造口回纳,术后未出现明显的短肠综合征症状。

关键词: 急性肠系膜静脉栓塞, 造口, 肠内营养, 护理

Abstract:

To summarize the nursing experience of a patient with multiple enterostomies after segmental small bowel resection for acute mesenteric vein embolism. Nursing points:early identification of necrosis of retained intestinal tubes and improvement of early warning care;active improvement of tissue perfusion for retained indeterminate necrotic intestinal tubes;relay enteral nutritional support for 4 stomas based on the collaborative care model;implementation of combined dressing changes for surgical incisions and stomas,control of incisional infections and peristoma dermatitis;attention to the psychological aspects of the patients and their families and provision of psychological support. The patient successfully underwent stoma retraction on the 42nd day after surgery,and no obvious short bowel syndrome occurred in the postoperative period.

Key words: Acute Mesenteric Vein Embolism, Stoma, Enteral Nutrition, Nursing Care