四种护理用具在大便失禁患者中的应用比较研究

Application comparison of four nursing devices in patients with fecal incontinence

目的综合比较人工肛袋、气管导管、气囊导尿管和纸尿裤在大便失禁患者护理中的应用效果,探讨更好的大便失禁护理方法。方法将160例大便失禁成年患者随机分为四组,每组各40例。甲组使用一次性肛门袋,乙组使用8～9号带囊气管导管接负压引流器,丙组使用24号气囊导尿管接负压引流器,丁组使用一次性成人纸尿裤,比较四组引流大便效果,所需护理人力、护理时数、护理成本以及肛周/骶尾部皮肤并发症发生情况。结果一次性肛门袋在引流大便效果、平均护理人力、平均护理时数、平均护理成本、肛周/骶尾部皮肤损伤等方面均优于气管导管、24号导尿管和一次性纸尿裤(P<0.01或P<0.05);气管导管和24号导尿管在平均护理人力、平均护理时数、平均护理成本、肛周/骶尾部皮肤损伤等方面均优于一次性纸尿裤(P均<0.01),引流大便效果劣于一次性纸尿裤(堵塞及脱出P均<0.01;渗漏P>0.05);气管导管在堵塞、平均护理人力、平均护理时数等方面均优于24号导尿管(P均<0.01),肠道损伤劣于24号导尿管(P<0.05)。结论大便失禁患者应用一次性肛门袋,能有效收集大便和预防并发症,减少护士工作量,提高护理工作效率,降低患者医疗成本,值得临床推广应用。

Objective To compare the effect of four nursing devices in patients with fecal incontinence. Method One-hundred and sixty adult patients with fecal incontinence were randomly divided into four groups, 40 cases in each group. Patients were nursed by artificial anus bag, endotracheal tube, aerocyst urethral catheter and disposable nappies, respectively. The drainage effect, nursing cost and skin complication of the sacrococcygeal and perianal ar- eas were recorded and analyzed. Result The effects of drainage by artificial anus bag were superior to endotraeheal tube, aeroeyst urethral catheter and disposable nappies in drainage effect, nursing cost and skin complication of the saerococcygeal and perianal areas （P〈0.01 or P〈0.05）. The endotraeheal tube and aerocyst urethral catheter were better than disposable nappies in nursing cost and skin complication of the sacrococcygeal and perianal areas （all P〈 0.01）, but inferior to disposable nappies in drainage effect. The endotracheal tube has advantage over aerocyst urethral catheter in drainage effect and nursing cost （all P〈0.01）, but has disadvantage in gut injury （P〈0.05）. Conclusion The artificial anus bag was superior to the other nursing devices in collecting defecate, preventing complications, reducing nursing cost and improving nursing work efficiency, and was well worth clinical popularizing and application.