1例胃癌根治术后患者发生复杂肠瘘的护理

doi:10.3761/j.issn.0254-1769.2026.08.015

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (8): 1112-1116.DOI: 10.3761/j.issn.0254-1769.2026.08.015

1例胃癌根治术后患者发生复杂肠瘘的护理

陈建芬¹(), 朱慧娣²^,^*(), DONG Kimberly³

¹ 浙江大学医学院附属第一医院护理部杭州市 310003
² 浙江大学医学院附属第一医院胃肠外科杭州市 310003
³ 美国零售药房协会加州药剂师协会加利福尼亚州洛斯加托斯 95032

收稿日期:2025-08-27 出版日期:2026-04-20 发布日期:2026-04-22
*通讯作者: 朱慧娣，E-mail：hzzhuhuidi0505@yeah.net
作者简介:陈建芬：女，本科，主管护师，E-mail：1489733397@qq.com
第一联系人：作者贡献声明
陈建芬：确定选题、收集病例、医院感染防控指导、撰写论文；朱慧娣：修改论文、整体把控论文质量；DONG Kimberly：用药管理指导
基金资助:
浙江省医药卫生科技计划项目(2023KY706)

Nursing care of a patient with complex intestinal fistula following radical gastrectomy for gastric cancer

CHEN Jianfen¹(), ZHU Huidi²^,^*(), DONG Kimberly³

¹ Department of Nursing， the First Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310003， China
² Gastrointestinal Surgery Department， the First Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310003， China
³ California Pharmacists Association， National Community Pharmacists Association（USA），Los Gatos， California 95032， USA

Received:2025-08-27 Online:2026-04-20 Published:2026-04-22
* Corresponding author: ZHU Huidi，E-mail：hzzhuhuidi0505@yeah.net
Funding program:
Zhejiang Provincial Medical and Health Science and Technology Plan Project(2023KY706)

摘要/Abstract

摘要：

总结1例胃癌根治术后多发性完全断裂复杂肠瘘患者的护理经验。护理要点：开展人工智能系统辅助监测的脓毒性休克预警及急救护理；建立腹腔-创面双重负压冲洗系统，加强引流，有效控制感染；加强开放创面的管理，促进组织修复；应用出血风险预测模型进行腹腔大出血的预防与控制；实施经远端肠瘘口肠内营养，解决营养支持难题；落实多重耐药菌混合感染的预防与控制。经过129 d的个体化护理，患者感染控制，营养状况改善，康复出院。

关键词: 肠瘘, 胃癌根治术, 感染, 脓毒性休克, 护理

Abstract:

This article summarized the nursing experience of a patient with complex intestinal fistula characterized by multiple complete intestinal disruptions following radical gastrectomy for gastric cancer. Key nursing interventions included：utilizing an AI-powered system for the early identification and warning of septic shock，enabling emergency rescue to save the patient’s life；establishing and optimizing a dual abdominal cavity-wound negative pressure irrigation system to effectively control infection；enhancing the management of the open wound to promote tissue repair；applying a hemorrhage risk prediction model to guide the prevention and control of massive intra-abdominal bleeding；establishing enteral nutrition access through the enteroatmospheric fistula to resolve nutritional support challenges；implementing comprehensive hospital infection control strategies throughout the treatment course. After 129 days of individualized nursing care，the patient’s infection was controlled，nutritional status improved，and the patient successfully underwent definitive surgery and was discharged upon recovery.

Key words: Intestinal Fistula, Radical Gastrectomy, Infection, Septic Shock, Nursing Care

陈建芬, 朱慧娣. 1例胃癌根治术后患者发生复杂肠瘘的护理[J]. 中华护理杂志, 2026, 61(8): 1112-1116.

CHEN Jianfen, ZHU Huidi, DONG Kimberly. Nursing care of a patient with complex intestinal fistula following radical gastrectomy for gastric cancer[J]. Chinese Journal of Nursing, 2026, 61(8): 1112-1116.

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1例胃癌根治术后患者发生复杂肠瘘的护理

Nursing care of a patient with complex intestinal fistula following radical gastrectomy for gastric cancer

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