回肠插管造口术后套囊压力监测频次优化方案的临床实践

Clinical Practice of Improved Cuff Pressure Monitoring Frequency Scheme for Ileal Intubation Stoma

目的探讨回肠插管造口术后套囊压力监测频次优化方案的应用效果,为减轻患者就医负担提供参考。方法2018年1月至2021年12月,采用整群抽样法选择在杭州市某三级甲等医院行直肠癌低位/超低位前切除+自闭保护性回肠插管造口术201例患者为研究对象,以2018年1月至2019年12月的114例患者为对照组,2020年1月至2021年12月的87例患者为观察组。对照组实施常规压力管理方案,观察组实施监测频次优化方案。比较两组患者粪便转流情况及并发症、插管拔除时间、插管期间专科护理门诊随访次数、压力监测和调节次数。结果两组患者插管造口粪便转流、并发症发生率的差异均无统计学意义(均P>0.05),插管拔除时间、插管期间患者专科护理门诊随访次数、术后插管期间压力监测和调节总次数的差异均有统计学意义(均P<0.05)。结论回肠插管造口术后套囊压力监测频次优化方案可减少专科护士工作量,减轻患者医院就诊负担。

Objective To investigate the application effect of improved cuff pressure monitoring frequency scheme for ileal intubation stoma,and to provide reference for reducing patients’medical burden.Methods From January 2018 to December 2021,201 patients with rectal cancer who underwent low/ultra-low anterior resection ileal spontaneously closed intubation stoma in a tertiary A hospital in Hangzhou were selected by the cluster sampling method.114 patients from January 2018 to December 2019 were included in the control group while 87 patients from January 2020 to December 2021 were included in the observation group.The control group implemented the routine pressure management program,while the observation group implemented the monitoring frequency optimization scheme.The fecal diversion and complications,intubation removal time,follow-up times of specialist nursing clinic during intubation,pressure monitoring and adjustment times were compared between the two groups.Results There was no statistically significant difference between the two groups in the incidence of incomplete fecal diversion,and the incidence of stoma complications(all P>0.05).There were statistically significant differences in intubation removal time,the time of follow-up visits in specialist nursing clinics,and the number of total pressure monitoring and adjustment times(all P<0.05).Conclusions The improved cuff pressure monitoring frequency scheme can reduce the workload of specialist nurses and the burden of patients.