一种体外膜肺氧合患者专用防护裙的设计与运用

Design and application of a specialized protective skirt for patients undergoing extracorporeal membrane oxygenation

体外膜肺氧合(ECMO)主要为心和(或)肺功能衰竭的急危重症患者提供持续的体外呼吸与循环,以维持患者生命,目前其作为一项高级器官支持技术在危重症领域中的应用越来越普遍。若选择双侧腹股沟处动、静脉进行穿刺实施ECMO时,患者无法使用传统的病服裤,导致患者隐私部位暴露、容易着凉,排便时容易污染床单被服,使患者不舒适的同时也增加了感染的概率;更换床单被服不仅增加了护士的工作量,而且容易造成管道移位或滑脱;使用病服裤也无法随时观察患者管道渗血、移位或脱出的情况。为此,河南省人民医院急诊重症监护室护理人员设计了一种ECMO患者专用防护裙,并获得了国家实用新型专利(专利号:ZL 2020208120022.9)。该ECMO患者专用防护裙主要由裙体、透明观察窗、臀部支撑气囊及便液收集袋等组成。透明观察窗方便进行穿刺部位及管路的观察;臀部支撑气囊充气后可以使患者肛周皮肤与二便隔开,避免失禁性皮炎发生;便液收集袋可以收集二便,保持床单的清洁。该防护裙结构简单,穿脱方便,在保护患者隐私、保证患者舒适的情况下,还能随时观察管道情况,适用于下肢置有管路或二便失禁的患者,有一定的临床应用和推广价值。

Extracorporeal membrane oxygenation(ECMO)provides continuous extracorporeal respiratory and circulatory support for patients with severe heart and lung failure,in order to maintain their lives.Currently,ECMO is an advanced organ support technology and its application in the clinical field of critical care is becoming increasingly common.When ECMO is implemented via percutaneous cannulation at the bilateral femoral artery and vein,the traditional patient pants cannot be used,which leads to exposure of privacy,easy catching of cold,and easy contamination of bed sheets and covers during defecation,making the patient uncomfortable and increasing the risk of infection.Changing bed sheets and covers not only increases the workload of nurses,but also easily causes pipeline displacement or slipping.It is inconvenient to observe the patient's bleeding,displacement,or dislodgement of the pipeline at any time when wearing patient pants.To solve the problems,nursing staff in the emergency intensive care unit of Henan Provincial People's Hospital have designed a protective skirt specifically designed for patients undergoing ECMO,which has obtained a National Utility Model Patent of China(patent number:ZL 2020208120022.9).The special protective skirt for patients with ECMO mainly consists of a skirt body,a transparent observation window,a hip support part,and a fecal collection part.The transparent observation window is convenient for the puncture site and pipeline observation.After the hip support part is inflated,the patient can separate the perianal skin and urine and feces to avoid the occurrence of incontinence dermatitis.The fecal collection part can collect urine and feces to keep the bed unit clean.The protective skirt has a simple structure and is easy to wear and take off.While protecting patient privacy and ensuring patient comfort,it can also observe the condition of the pipeline at any time.It is suitable for patients with lower limb catheterization or urinary and fecal incontinence,and has certain clinical application and promotion value.