造口袋负压吸引用于危重病人大便失禁肛周皮肤护理的效果观察

Effects of Ostomy Suction on Perianal Skin Care of Critically Ill Patients with Fecal Incontinence

目的探讨造口负压吸引装置在合并大便失禁的危重病人肛周皮肤护理中的效果。方法对于大便失禁的危重病人,通过对肛门使用造口袋连接2根一次性引流管,将1根连接中心负压吸引装置进行间断或者持续负压吸引为吸引管,压力-20～-40 kPa,另1根定期用灌食空针抽取温开水或生理盐水清洗为冲洗管,冲洗结束后用橡皮筋捆扎。结果25例发生大便失禁危重病人中,造口袋连接负压吸引装置使用最长15.6 d,最短3.3 d,平均6.7 d;除1例Ⅲ度肛周皮肤损伤病人死亡外,肛周皮肤损伤Ⅰ度和Ⅱ度共16例病人停用造口袋连接负压吸引装置时,皮肤均愈合、潮红消退;肛周皮肤完好8例病人无出现皮肤损伤。结论造口袋负压吸引装置能够避免大便对肛周皮肤的刺激,保护肛周皮肤;加强危重病人观察,保证危重病人的安全,降低护理成本,有效减少护士的工作量,可以在ICU推广使用。

Objective To explore the effects of ostomy suction on perianal skin care of critically ill patients with fecal incontinence. Methods The participants included 25 patients with fecal incontinence. The anal ostomy bags were connected with two disposable drainage tubes. Tube A was connected with a central suction device, and was set in an intermittent or continuous negative pressure of -20--40 kPa and tube B was regularly cleaned by feeding empty needle extracting warm water or saline, and was then bundled with rubber bands after rinse. Results Among 25 patients, the maximum duration of the ostomy bag connecting suction device was 15.6 days, and the minimum 3.3 days. Except one patients with IU perianal skin damage had died, sixteen patients with I and II perianal skin damage recovered and their skin flushing were subsided; eight patients with intact perianal skin showed no skin damage after the usage of ostomy bag connecting suction devices. Conclusion The ostomy bag connecting suction devices is effective for avoiding the perianal skin irritation of stool and protecting perianal skin intact, which is also helpful in ensuring the security of critically ill patients and reducing care costs. Meanwhile, ostomy bag connecting suction devices effectively reduce the workload of nurses and could be widely promoted in ICU care.