Hartamann's术式造瘘还纳病人术前远端肠道准备效果观察

Observation on clinical effect of bowel preparation on returning distal intestinal segment in Hartamann's building fistula

目的:探讨三步灌肠法对行造瘘还纳病人远端肠段肠道准备的护理体会。方法:回顾总结我科2003年以来59例患者的临床资料,分为实验组和对照组。实验组用改良的石蜡油保留灌肠,等渗生理盐水清洁灌肠,甲硝唑、链霉素溶液保留灌肠的三步灌肠法行造瘘远端的肠道准备,对照组用传统的清洁灌肠法对远端肠段行肠道准备。结果:用改进后的三步灌肠法为Hartamann's术式造瘘还纳病人行术前远端肠段的肠道准备在灌肠的清洁度上有显著效果(P<0.01),减少了病人灌肠过程中的不适(P<0.05),行造瘘还纳后无肠瘘发生。结论:改进后的灌肠方法提高了灌肠效果,无术后肠瘘,明显减少了病人腹痛的不适和痛苦。

Objective：To review the experiences of bowel preparation by 3-step enema for returning distal intestinal segment by building fistula.Methods：59 cases were retrospectively summarized in our hospital since 2003, which were divided into the experimental group and the control group.The experimental group was treated with 3-step enema,i.e, the improved paraffin oil retention enema,isotonic saline cleaning enema and metronidazole,streptomycin solution retention enema;the control group was used the traditional method of cleaning enema for bowel preparation.The intestinal cleaning effects in the two groups were evaluated by 3 ways,i.e, the intestinal mucosa clarity seen by doctor in operation, the abdominal pain level in enema and intestinal fistula occurred after operation.Results ：The improved 3-step enema had obvious effect in cleanness for bowel preparation of returning distal intestinal segment by Hartamann＇s building fistula （P〈0.01） and reduced discomfort of the patients during enema （P〈0.05）.No intestinal fistula occurred after intestinal segment returning by building fistula.Conclusion： The improved enema increases the effect of enema without postoperative intestinal fistula and reduces abdominal pain and discomfort of the patients significantly.