急性重症胰腺炎术后结肠漏的相关因素及护理策略分析  

Related factors and nursing strategy of postoperative colonic fistula in patients with severe acute pancreatitis

作　　者：郑春燕 张嘉丽 陈芳玲 Zheng Chunyan Zhang Jiali Chen Fangling(Department of Critical Care Medicine, People＇s Hospital of Linghua New District, Shenzhen, Guangdong, 518109, China Department of Ambulant Clinic, Longhua hospital, People＇s Hospital of Longhua New District, Shenzhen, Guangdong, 518109, China)

机构地区：[1]深圳市龙华新区人民医院重症医学科,广东深圳518109 [2]深圳市龙华新区人民医院龙华医院门诊部,广东深圳518109

出　　处：《结直肠肛门外科》2017年第2期253-256,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的分析急性重症胰腺炎术后发生结肠漏的危险因素,并针对性制定护理对策。方法将2014年2月至2016年8月本院收治的92例急性重症胰腺炎接受手术治疗的患者为研究对象,分析患者临床资料,了解患者术后结肠漏发生情况,分析发生结肠漏的影响因素。结果本次研究对象92例急性重症胰腺炎接受手术患者中,共有44例出现结肠漏情况,占47.83%。未出现结肠漏患者与出现结肠漏患者在年龄、性别、手术时机选择、术中创伤部位范围、引流管留置时间等临床参数方面比较,差异均有统计学意义(均P<0.05)。行Logistic回归分析,发现年龄、性别、手术时机选择、术中创伤部位范围及引流管留置时间均是发生结肠漏的独立影响因素。结论积极做好急性胰腺炎患者入院后基础护理服务,术后严密监测患者病情、观察引流管情况,对于发生结肠漏的患者采取积极措施,利于改善患者预后。Objective To analyze the risk factors of postoperative colonic fistula in patients with severe acute pancreatitis（SAP）.Methods 92 cases of surgical treatment of severe acute pancreatitis in our hospital between February 2014. and August 2016 were selected. We analyzed the characteristics of patients, and incidence of postoperative colonic fistula rate. Results 92 patients with acute severe pancreatitis underwent surgery, with a total of 44 cases（47.83%） of colonic fistula. There were significantly differences in age,gender, timing of surgery, intraoperative trauma, location of intraoperative drainage tube and drainage tube indwelling time between patients who developed and who did not develop postoperative colonic fistula（P〈0.05）. Logistic regression showed that age, gender,timing of surgery, intraoperative trauma, location of intraoperative drainage tube and drainage tube indwelling time were the independent factors predicting postoperative colonic fistula. Conclusion Good basic nursing service for the patients after acute pancreatitis,including positive physical examination, drug treatment, preoperative preparation measures, postoperative close monitoring of patients,monitoring the surgical site and drainage tube could improve the prognosis of patients with severe acute pancreatitis undergoing surgical treatment.

关 键 词：急性重症胰腺炎 结肠漏 危险因素 护理干预 

分 类 号：R473.6[医药卫生—护理学]