1例腹部伤口全层裂开患者经空肠造口行肠内营养的护理

doi:10.3761/j.issn.0254-1769.2022.13.014

中华护理杂志 ›› 2022, Vol. 57 ›› Issue (13): 1623-1627.DOI: 10.3761/j.issn.0254-1769.2022.13.014

1例腹部伤口全层裂开患者经空肠造口行肠内营养的护理

代雯晴(), 辛霞(), 金鲜珍, 樊慧, 乔莉娜

710061 西安市西安交通大学第一附属医院护理部（代雯晴,辛霞）,普通外科（金鲜珍,樊慧,乔莉娜）

收稿日期:2021-08-10 出版日期:2022-07-10 发布日期:2022-06-29
通讯作者: 辛霞,E-mail： 1074116614@qq.com
作者简介:代雯晴：女,本科（硕士在读）,E-mail： 1256807025@qq.com
基金资助:
陕西省重点研发计划(2020SF-230)

Nursing care of a patient with full-thickness abdominal wound dehiscence undergoing enteral nutrition through jejunostomy

DAI Wenqing(), XIN Xia(), JIN Xianzhen, FAN Hui, QIAO Lina

Received:2021-08-10 Online:2022-07-10 Published:2022-06-29

摘要/Abstract

摘要：

总结1例腹部切口全层裂开患者经空肠造口行肠内营养的护理。护理要点：积极进行全身抗感染治疗,动态评估伤口,负压冲洗引流渗液;造口及周围皮肤管理,预防潮湿相关性皮炎;全程营养风险评估,经空肠造口行肠内营养;采用多模式镇痛,减轻患者疼痛症状;开展阶段性心理干预,正性引导患者认识疾病;制订出院指导手册,坚持全程随访计划。经91 d精心治疗与护理患者伤口完全愈合,居家期间完全肠内营养,营养状况良好,行造口还纳术,效果显著,患者满意。

关键词: 全层裂开, 空肠造口, 短肠综合征, 肠液回输, 肠内营养

Abstract:

To summarise the care of a patient with a full abdominal incisional laceration who underwent enteral nutrition through jejunostomy. The key points of care included active fight against infection and intravenous hyper-nutrient therapy;dynamic assessment of the wound,negative pressure flushing to drain the exudate;stoma and surrounding skin management to prevent moist dermatitis;whole-course nutritional risk assessment and enteral nutrition through jejunostomy;multi-modal analgesia to reduce the pain symptoms of the patient;stage psychological intervention to positively guide the patient’s understanding of the disease; formulation of a discharge instruction manual and adherence to the full follow-up plan. After 91 days,the wound of the patient healed completely,during which the patient was given total enteral nutrition during the household period with good nutritional condition. The intestinal rejection was performed with good effects and patient satisfaction.

Key words: Total Laceration, Jejunostomy, Short Bowel Syndrome, Intestinal Fluid Reinfusion, Enteral Nutrition

代雯晴, 辛霞, 金鲜珍, 樊慧, 乔莉娜. 1例腹部伤口全层裂开患者经空肠造口行肠内营养的护理[J]. 中华护理杂志, 2022, 57(13): 1623-1627.

DAI Wenqing, XIN Xia, JIN Xianzhen, FAN Hui, QIAO Lina. Nursing care of a patient with full-thickness abdominal wound dehiscence undergoing enteral nutrition through jejunostomy[J]. Chinese Journal of Nursing, 2022, 57(13): 1623-1627.

参考文献 15

[1]	颜伟慧, 戴丽娜. 新生儿坏死性小肠结肠炎小肠造瘘术后临床治疗专家共识[J]. 中华小儿外科杂志, 2016, 37(8):563-567.
	Yan WH, Dai LN. Expert consensus on the clinical management of neonatal necrotizing small bowel colitis after small bowel fistula[J]. Chin J Pediatr Surg, 2016, 37(8):563-567.
[2]	龚剑峰. 短肠综合征的病理生理改变及临床表现[J]. 中华炎性肠病杂志, 2022, 6(1):22-26.
	Gong JF. Pathophysiology and clinical manifestations of short bowel syndrome[J]. Chin J Inflamm Bowel Dis, 2022, 6(1):22-26.
[3]	吴国豪, 张知格. 短肠综合征的营养及相关治疗[J]. 中华炎性肠病杂志, 2022, 6(1):27-30.
	Wu GH, Zhang ZG. Management of nutrition and contemporary treatment for short bowel syndrome[J]. Chin J Inflamm Bowel Dis, 2022, 6(1):27-30.
[4]	O’Neill CH, Moore J. Complications of jejunostomy feeding tu-bes:a single center experience of 546 cases[J]. J Gastrointest Surg, 2020, 24(4):959-963. DOI URL
[5]	Holmén A, Hayami M, Szabo E, et al. Nutritional jejunostomy in esophagectomy for cancer,a national register-based cohort study of associations with postoperative outcomes and survival[J]. Langenbecks Arch Surg, 2021, 406(5):1415-1423. DOI URL
[6]	胡晓静, 张玉侠, 曹云. 1例短肠综合征早产儿应用肠内回输技术的护理[J]. 中华护理杂志, 2015, 50(9):1147-1148.
	Hu XJ, Zhang YX, Cao Y. Nursing care of a premature infant with short bowel syndrome treated by enteral refeeding technique[J]. Chin J Nurs, 2015, 50(9):1147-1148.
[7]	薛阳阳, 施天奇, 吴翠丽, 等. 1例严重腹部外伤致肠空气瘘患者行二次腹壁植皮术的护理[J]. 中华护理杂志, 2017, 52(1):80-83.
	Xue YY, Shi TQ, Wu CL, et al. Nursing care of a patient with severe abdominal traumatic enteroatmospheric fistula undergoing a second skin grafting:a case report[J]. Chin Nurs Res, 2017, 52(1):80-83.
[8]	来玉民, 刘岱, 杨荣. 磺胺嘧啶银脂质水胶敷料用于皮肤软组织损伤创面换药的效果[J]. 中华现代护理杂志, 2012, 18(2):145-146.
	Lai YM, Liu D, Yang R. Effect of urgotul used in wounds of the skin soft tissue injury[J]. Chin J Mod Nurs, 2012, 18(2):145-146.
[9]	陈红涛, 董彩梅, 吕冬, 等. 藻酸盐敷料在伤口创面护理中的应用进展[J]. 护理研究, 2015, 29(3):257-259.
	Chen HT, Dong CM, Lü D, et al. Application progress on alginate dressing wound care[J]. Chin Nurs Res, 2015, 29(3):257-259.
[10]	朱晋国, 王健, 和源, 等. 小肠双造口和肠液回输在重度腹腔感染患者的应用[J]. 中华胃肠外科杂志, 2015, 18(7):667-670.
	Zhu JG, Wang J, He Y, et al. Application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection[J]. Chin J Gastrointest Surg, 2015, 18(7):667-670.
[11]	罗娟, 马云丽, 赵允召, 等. 回肠造口术后切口裂开合并肠空气瘘患儿的护理[J]. 中华护理杂志, 2019, 54(5):727-729. DOI
	Luo J, Ma YL, Zhao YZ, et al. Nursing care of a child with disruption of wound and intestinal fistula after ileostomy[J]. Chin J Nurs, 2019, 54(5):727-729.
[12]	施倩倩, 王新, 侍玲, 等. 1例切口全层哆裂合并肠造口皮肤黏膜分离患儿的护理[J]. 中华护理杂志, 2021, 56(5):751-755. DOI
	Shi QQ, Wang X, Shi L, et al. Nursing care of a child with incision full-thickness fissure combined with enterostomy skin and mucosal separation[J]. Chin J Nurs, 2021, 56(5):751-755.
[13]	贾静, 仇晓溪, 吴晓苏. 造口治疗师在慢性伤口处理过程中疼痛管理探讨[J]. 护理研究, 2010, 24(24):2217-2219.
	Jia J, Qiu XX, Wu XS. Probe into pain management of stoma therapeutist in treating process for patients with chronic wound[J]. Chin Nurs Res, 2010, 24(24):2217-2219.
[14]	姜丽英, 孙剑梅, 盛丽琴, 等. 急性伤口延迟愈合的原因及护理对策[J]. 解放军护理杂志, 2014, 31(10):50-52.
	Jiang LY, Sun JM, Sheng LQ, et al. Nursing strategy and reason for delayed union of acute wound in outpatients[J]. Nurs J Chin PLA, 2014, 31(10):50-52.
[15]	易慧, 侯铭, 魏苏艳, 等. 101例肠造口患者健康教育需求调查分析[J]. 护理学报, 2017, 24(17):9-11.
	Yi H, Hou M, Wei SY, et al. Needs of health education in patients with ostomy:a 101-case study[J]. J Nurs, 2017, 24(17):9-11.

1例腹部伤口全层裂开患者经空肠造口行肠内营养的护理

Nursing care of a patient with full-thickness abdominal wound dehiscence undergoing enteral nutrition through jejunostomy

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 15

相关文章 15

编辑推荐

Metrics

[1]	谢玉生, 黄蓉蓉, 赵雪, 马蕾, 胡雁, 杨倩, 王乾沙, 明玥. 成人重度烧伤患者肠内肠外营养的证据总结[J]. 中华护理杂志, 2024, 59(9): 1106-1113.
[2]	吴太琴, 甘秀妮, 高燕, 周雯. 肠内营养再喂养综合征护理知信行问卷的编制及信效度检验[J]. 中华护理杂志, 2024, 59(7): 835-841.
[3]	余昆容, 李凡, 侯青敏, 徐颖臻, 李小容, 马俊, 陈燕, 关玉霞. 减少胃残余量监测频率对经鼻肠内营养患者影响的研究[J]. 中华护理杂志, 2024, 59(5): 582-587.
[4]	吴白女, 米元元, 郑义, 张柳柳, 章毛毛, 邾萍, 刘春丽, 吴冰, 羌燕. 食管癌术后患者肠内营养相关性腹泻管理流程的制订与应用[J]. 中华护理杂志, 2024, 59(3): 338-344.
[5]	倪秀梅, 胡少华, 韩江英, 付红, 蔡月红, 赵利灿, 王继海, 詹雪梅. 护士主导的床旁超声在ICU肠内营养患者腹胀管理中的应用[J]. 中华护理杂志, 2024, 59(17): 2123-2129.
[6]	卜黎静, 程飞儿, 张爱琴, 赵敏燕, 张议丹. 危重症患者肠内营养喂养不耐受风险预测模型的构建及验证[J]. 中华护理杂志, 2024, 59(15): 1877-1883.
[7]	时铭, 厉蒙杰, 傅蔓易, 方雨慧, 屠杭佳, 张书怡, 何桂娟. 基于移动医疗的患者居家管饲营养管理的范围综述[J]. 中华护理杂志, 2024, 59(15): 1884-1890.
[8]	朱慧娣, 章梅云, 江月红, 徐巧英, 陈叶红. 1例急性肠系膜静脉栓塞患者行节段性小肠切除的护理[J]. 中华护理杂志, 2024, 59(14): 1757-1760.
[9]	游俊杰, 刘波, 陈梦玲, 沈玉珊, 郑思琳, 黄敏. 重症肺炎患者营养管理的最佳证据总结[J]. 中华护理杂志, 2024, 59(13): 1616-1623.
[10]	刘欢, 杜爱平, 张耀丹, 尹万红, 田永明. 重症患者气道操作相关肠内营养喂养中断的研究进展[J]. 中华护理杂志, 2024, 59(12): 1525-1530.
[11]	马骁, 石海燕, 王湘, 王军, 韩中彦, 张华果. 电磁导航床旁鼻肠管置管技术在老年卧床患者中的应用[J]. 中华护理杂志, 2024, 59(1): 70-76.
[12]	杜静, 孙皎, 李婷, 杨阳, 赵晓甦. 危重症患者肠内营养并发胃潴留护理的最佳证据总结[J]. 中华护理杂志, 2023, 58(23): 2856-2863.
[13]	梅伶俐, 凌云, 胡艳, 翁冬芳, 周金燕, 陈朔晖. 短肠综合征继发肠衰竭患儿父母营养照护体验的质性研究[J]. 中华护理杂志, 2023, 58(20): 2452-2458.
[14]	袁梦湄, 黄晓霞, 唐佳迎, 封秀琴. 以腹内压监测为导向的腹腔高压患者肠内营养护理方案的构建及应用[J]. 中华护理杂志, 2023, 58(12): 1413-1421.
[15]	全殷殷, 张帅, 陈娟红, 刘飞跃, 姚惠萍. ICU患者早期肠内营养耐受性监测系统的构建与应用[J]. 中华护理杂志, 2022, 57(7): 773-778.