1例严重腹部外伤致肠空气瘘患者行二次腹壁植皮术的护理

Nursing care of a patient with severe abdominal traumatic enteroatmospheric fistula undergoing a second skin grafting:a case report

总结了1例严重腹部外伤致肠空气瘘行二次腹壁植皮术的护理经验。护理要点包括:密切监测患者生命体征变化,积极预防感染性休克;及时封堵肠空气瘘并引流溢出肠液;加强腹壁植皮创面的保护;加强腹腔双套管有效冲洗、引流以控制腹腔感染进一步发展;早期营养支持以肠外营养为主,辅以小剂量肠内营养,以改善肠道的免疫功能;创伤后患者的压力适应能力同样需要给予足够的重视。肠空气瘘及时有效封堵为后期腹壁创面植皮的生长奠定了基础。

This report summarized the nursing experience of caring for twice skin grafts in a patient with en- teroatmospheric fistula after trauma. Keys to nursing success including：monitoring vital signs closely to prevent sep- tic shock,blocking enteroatmospherie fistula （EAF） and sucking overflowed intestinal juice timely,promoting the protection of the graft on abdominal wall wounds,strengthing drainage and lavage with the application of abdominal double cannula to control abdominal infection,early nutrion support with parenteral nutrition in combination with trophic enteral nutrition to improve intestinal immune function,and attaching importance to post-traumatic stress disorder. Timely blocking of EAF is the bases of skin graft healing.