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肠皮肤瘘的管理考量

Considerations for the management of enterocutaneous fistula.

作者信息

Metcalf Christine

机构信息

Stoma Care Clinical Nurse Specialist, St Mark's Hospital, London North West NHS Trust.

出版信息

Br J Nurs. 2019 Mar 14;28(5):S24-S31. doi: 10.12968/bjon.2019.28.5.S24.

Abstract

Enterocutaneous fistula is an abnormal connection between the gastrointestinal tract and skin. Management includes early recognition and treatment of sepsis, reducing fluid and electrolyte homeostasis, nutrition support, wound management and a carefully timed surgical procedure. A multidisciplinary approach is required for successful management of these patients with one of the most challenging and resource-demanding aspects being local control of the effluent, requiring the skill and support of the specialist stoma care nurse. The inability to contain the fistula can be a source of morbidity for the patient, as they will experience pain and severe discomfort from the skin when leakages occur. Enterocutaneous fistula can result in intestinal failure, which is often fatal if not managed correctly.

摘要

肠皮肤瘘是胃肠道与皮肤之间的异常连接。管理措施包括早期识别和治疗脓毒症、维持液体和电解质平衡、营养支持、伤口处理以及适时进行外科手术。对于这些患者的成功管理需要多学科方法,其中最具挑战性和资源需求最大的方面之一是对流出物的局部控制,这需要造口护理专科护士的技能和支持。无法控制瘘管可能会给患者带来发病风险,因为渗漏发生时患者会感到皮肤疼痛和严重不适。肠皮肤瘘可导致肠衰竭,如果处理不当往往会致命。

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