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回肠造口术后伤口感染并肠脱垂患儿的护理:一例报告

Nursing of a child with wound infection and bowel evisceration following ileostomy: a case report.

作者信息

Li Sha

机构信息

Department of Neonatal Surgery, Guangzhou Women and Children's Medical Center, Guangzhou, China.

出版信息

Ann Palliat Med. 2020 Jul;9(4):2367-2374. doi: 10.21037/apm-20-1189. Epub 2020 Jul 20.

Abstract

Children after ileostomy, due to excreta characteristics and improper nursing and other reasons, causes waste collection difficulties. Leakage of intestinal waste leads to wound infection. Wound infections further increase the difficulty of collecting excreta. Alternate circulation exacerbates wound infection. The wound was seriously infected until the whole layer split and the intestinal tract was exposed. Even endangering life. Thus, in these cases, it is particularly important to effectively collect bowel contents at the intestinal stoma, promote wound healing, and save lives. This article summarizes our experience in the nursing of a pediatric patient with wound infection and bowel evisceration following ileostomy. Comprehensive assessment of children, setting care targets, implementing holistic care. For local situations, the ostomy devices and supplies were appropriately used to enable the effective collection of liquid stool. Guided by the theory of wound bed preparation and wet healing theory, a self-made simple negativepressure device and modern wound dressings were used in different stages of wound development. In order to effectively manage wound exudate, remove necrotic tissue and promote granulation growth. Finally, promoting wound healing. Through the above nursing methods, oral waste can be collected effectively. The open bowel is well protected. The wounds were smoothly healed, and the patient was discharged on day 32.

摘要

回肠造口术后的儿童,由于排泄物特性及护理不当等原因,导致粪便收集困难。肠内排泄物渗漏引发伤口感染。伤口感染进一步增加了排泄物收集的难度。循环交替加剧了伤口感染。伤口严重感染直至全层裂开,肠道外露。甚至危及生命。因此,在这些情况下,有效收集肠造口处的肠内容物、促进伤口愈合并挽救生命尤为重要。本文总结了我们对一名回肠造口术后伤口感染并肠外置的儿科患者的护理经验。对患儿进行全面评估,设定护理目标,实施整体护理。针对局部情况,合理使用造口装置及用品,以有效收集稀便。以伤口床准备理论和湿性愈合理论为指导,在伤口发展的不同阶段使用自制简易负压装置及现代伤口敷料。以有效管理伤口渗出液,清除坏死组织,促进肉芽生长。最终促进伤口愈合。通过上述护理方法,可有效收集肠内排泄物。外露肠道得到良好保护。伤口顺利愈合,患者于第32天出院。

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