穿刺式空肠造瘘术在腹部大手术中的应用与护理

The nursing experience in needle catheter jejunostomy used in abdorminal major surgery

目的:探讨危重患者术后穿刺式空肠造瘘术肠内营养的护理经验.方法:对48例危重患者术中经空肠穿刺放置Flocare可裂式空肠造瘘管(穿刺式空肠造瘘术),术后早期经造瘘管行肠内营养,观察患者肠内营养时胃肠道及造瘘管的并发症.结果:48例患者空肠造瘘管应用良好,4例患者发生导管阻塞,在介入引导下用导丝予以疏通后重新应用;穿刺处无红肿和炎性渗出及其他造瘘管相关发并症,均在7～28天内拔除造口管.结论:穿刺式空肠造瘘术可用于腹部大手术后患者早期肠内营养,心理护理、完善的营养计划、造瘘管的护理及观察营养时可能出现的并发症等良好细致的护理是成功实施肠内营养的保证.

Objective： To explore the nursing experience in needle catheter jejunostomy （NCJ） used in critically ill patients after the major abdominal surgery. Methods： NCJ with Flocare splitable jejunostomy catheter to 48 cases of critically ill, postoperative enteral nutrition was administeved （EN） early and complcations related to FAN and NCJ were observed. Results： NCJ application in 48 patients were effective, catheter obstruction occurred in 4 cases and mused after de-oppolation, no inflame, extidation and other complications related to catheter occurred, all catheters were removed during 7 - 28 d after the operation. Conclusion： NCJ can be used early in the major abdomen postoperative patients, fine nursing cares such as psychological nursing, perfect plan and finding the early complications of nutrition are the essentials successful EN application.