改良自制便携负压封闭引流装置应用于肠外瘘患者漏液管理及皮肤护理的效果评价

Evaluation of Leakage Management and Skin Care by Improved Homemade Mobile Vacuum Sealing Drainage Device for Enterocutaneous Fistula Patients

目的探讨改良自制便携负压封闭引流装置用于肠外瘘瘘口周围皮肤及漏液管理的效果,解决困扰护理人员漏液收集和患者活动不方便的难题。方法利用亲水纤维银离子抗菌敷料、防漏条、皮肤保护膜、透明敷贴、吸痰管、输液器、防反流负压引流瓶自制便携式引流装置,对2011年1月-2013年9月收治的肠外瘘患者,按收治时间分为传统治疗组和便携负压封闭治疗组,分别采用中心负压吸引传统方法和便携式负压封闭引流法对漏液进行管理,通过对两组患者的伤口愈合时间及周围皮肤红肿、破溃、浸渍情况的比较,验证便携负压封闭引流装置的应用效果。结果便携负压封闭治疗组患者瘘口愈合时间较传统治疗组短,两组比较差异有统计学意义(P<0.05);便携负压封闭治疗组患者周围皮肤红肿、浸渍、破溃发生率也低于传统治疗组患者。结论使用改良自制便携式负压引流装置可减少肠外瘘患者周围皮肤发生红肿、浸渍、破溃等并发症,且利于活动,减少痛苦。

Objective To explore the leakage management and skin care by improved homemade portable vacuum sealing drainage device used for enterocutaneous fistula,in order to solve such confusing problems as leakage collection and nursing for patients with inconvenient activity.Methods The homemade portable vacuum sealing drainage device was made by using hydrophilic fiber of silver ion antimicrobial dressings,leak-proof strings,skin protective film,transparent patches,sputum suction tube,bottle of portable infusion,and negative pressure drainage bottle.Between January 2011 and September 2013,patients with enterocutaneous fistula admitted into our hospital were divided into traditional treatment group and portable vacuum sealing treatment group according to the admission time,and traditional center negative pressure suction treatment and portable negative pressure drainage method were used respectively for the two groups of patients.We verified the effect of the mobile vacuum sealing drainage device through comparing these two groups in terms of wound healing time,redness,burst and impregnation of the skin.Results The wound healing time was significantly shorter for patients in the portable vacuum sealing drainage treatment group（P〈0.05）,and patients in this group also had a lower occurrence of skin redness,impregnation and burst.Conclusion Homemade portable negative pressure drainage device for enterocutaneous fistula patients can reduce the incidence of skin complications such as redness,impregnation and burst,promote patients＇ activity,and reduce the patients＇ pain.