3例腹膜透析患者并发胸腹瘘的护理

Nursing of three patients with continuous ambulatory peritoneal dialysis complicated by abdominal fistula

目的总结持续非卧床性腹膜透析（continuous ambulatory peritoneal dialysis,CAPD）患者并发胸腹瘘的护理方法。方法对2013年1月-2014年9月本科室收治的3例CAPD并发胸腹瘘患者进行护理,包括病情观察、胸腔引流、低容量透析和健康指导等。结果经处理3例CAPD发生胸腹瘘患者2例退出CAPD,改为维持性血液透析,1例暂停CAPD 4周后继续接受CAPD治疗,随访腹透过程顺利,超滤可。结论及早发现胸腹瘘并进行胸腔穿刺引流、低容量透析护理和健康指导,可减轻患者痛苦,提高患者的生存质量。

Objective To investigate nursing of patients with continuous ambulatory peritoneal dialysis （CAPD） complicated by abdominal fistula. Methods Three patients with CAPD complicated by abdomial fistula who were treated in the nephrology department from January 2013 to September 2014 were nursed, including disease observation, chest drainage, measurable CAPD and health education. Result Two patients eventually turned to hemodialysis and 1 cases took pleural elemene injection 20 mL ＋lidocaine 5 mL, suspended peritoneal dialysis for 4 weeks to continue to receive the peritoneal dialysis treatment. Conclusions Abdominal fistula can be detected early based on clinical manifestations. Doctors and nurses in coordination, early treatment can reduce the pain of patients and the occurrence of complications.