薄膜敷料在经皮肾穿刺造瘘术后患者造瘘口护理中的应用  

Application of transparent film dressing in fistula nursing of patients with PCN

作　　者：王玫艳[1] 王香妮 孙继英[2] 阮瑞霞[1] 牛建瑞[1] 刘小明[1] 吴永红[1] 

机构地区：[1]西安交通大学第一附属医院门诊换药中心,710061 [2]西安交通大学第一附属医院门诊部,710061 [3]新疆医科大学护理学院,乌鲁木齐830061

出　　处：《中华现代护理杂志》2016年第32期4721-4724,共4页Chinese Journal of Modern Nursing

摘　　要：目的探讨薄膜敷料在经皮肾穿刺造瘘术后造瘘口护理中的应用效果。方法选取40例盆腔肿瘤导致肾后性肾衰竭经皮肾穿刺造瘘术后需要长期留置造瘘管的患者为研究对象，采取自身前后对照研究方法，干预前应用传统的无菌纱布和胶布护理造瘘口，干预后使用薄膜敷料覆盖造瘘口。结果干预前患者普遍担心脱管和感染；干预后，患者日常生活，如沐浴、睡觉姿势、活动等的舒适感明显高于干预前；肾造瘘口局部不良反应发生率低于干预前，差异有统计学意义（P〈0．01）；干预前胶布松脱时间为（5．47±1．48）d，干预后薄膜敷料松脱卷边时间为（14．22±1．99）d，差异有统计学意义（P〈0．01）。结论薄膜敷料粘性稳定、防水、防菌、透气和低致敏等优点，能够很好地保护造瘘口和固定造瘘管。适用于长期肾造瘘患者的造瘘口护理。Objective To evaluate the clinical application effect of transparent film dressing in fistula nursing of patients with percutanueous nephrostomy （PCN）.Methods By using before-after self control study method, 40 patients with pelvic tumor that caused by postrenal renal failure, and needed long-term fistula remained after PCN surgery were selected as the research object. Conventional sterile gauze and tape were used to nurse the fistula before intervention and transparent film dressing was used after intervention.Results Patents always worried about trachea cannula exodus and infection before intervention. After intervention, the comfort degree of their daily life （like showering, sleeping and daily activities） was obviously higher than that before intervention （P〈0.01）. The incidence of renal fistula local adverse effect after intervention is relatively low. And the difference was statistically significant （P〈0.01）. Before intervention, the tape was loosing in （5.47±1.48） days, there were three cases of accidental trachea cannula exodus; and after intervention, transparent film dressing hemmed in （ 14.22± 1.99） days, and no accidental trachea cannula exodus occurred （P〈0. 01 ） ; and no hyper-sensitive cases happened with the transparent film dressing. Conclusions The transparent film dressing has the advantages of stable viscosity, waterproofing, fungi-proofing, breathability and hypoallergenic, etc. It can well protect and fix the fistula, and it is suitable for nursing care of patients with long-term renal fistula.

关 键 词：肾造口术 经皮 肾造瘘口 薄膜敷料 舒适度 

分 类 号：R473.6[医药卫生—护理学]