基于舒适管理的经皮肝穿刺胆道引流术后切口渗液的护理效果探讨  

Comfort-based nursing care for the management of incision exudate after percutaneous transhepatic biliary drainage: discussion on its clinical effect

作　　者：马益敏[1] 肖玲[1] 傅荣春 马丽 吴健[1] MA Yimin;XIAO Ling;FU Rongchun;MA Li;WUJian.(Department of Interventional Radiology, Taixing Municipal People ＂s Hospital, Taixing, Jiangsu Province 225400, Chin)

机构地区：[1]江苏省泰兴市人民医院介入科,225400

出　　处：《介入放射学杂志》2018年第7期691-694,共4页Journal of Interventional Radiology

摘　　要：目的探讨经皮肝穿刺胆道引流术(PTBD)后,基于舒适管理的经皮穿刺点周围渗漏的护理效果。方法选择PTBD术后胆汁经穿刺点渗漏患者22例,随机分为对照组(n=12),观察组(n=10),对照组采用传统护理方法,观察组采用两件式尿路造口袋收集渗出液并固定引流管,对比两组临床应用与护理效果。结果观察组采用两件式尿路造口袋收集渗出液并固定引流管的患者舒适度、睡眠质量明显高于对照组(P<0.05),观察组伤口周围皮炎的发生率、敷料及衣被污染率、日均护理时数、换药次数、换药费用均明显低于对照组(P<0.05),差异具有统计学意义。结论采用两件式造口袋收集渗漏胆汁,同时固定引流管,可以减少胆汁对局部皮肤的刺激,促进舒适,提高生活质量,毋需每天频繁更换敷料,减少了医护人员的工作量,减轻了患者的经济负担,同时也使引流量的统计更准确。Objective To evaluate the clinical effect of comfort-based nursing care in managing the incision exudate around puncture point after percutaneous transhepatic biliary drainage （PTBD）. Methods A total of 22 patients with incision exudate around puncture point after PTBD were enrolled in this study. The patients were randomly divided into the control group （n=12） and the observation group （n=10）. Traditional nursing measures were executed for patients of the control group, while comfort-based nursing measures, i.e. using two-piece urinary tract ostomy bag to collect exudate and to fix the drainage tube, were carried out for patients of the observation group. The clinical and nursing effects were compared between the two groups. Results The degree of comfort and the sleep quality in the patients of the observation group were significantly better than those in the patients of the control group （P〈0.05）. The incidence of peri- wound dermatitis, the contamination rate of dressing and clothing, the mean nursing time per day, the times of dressing change and the dressing-change cost in the patients of the observation group were significantly lower than those in the patients of the control group, the differences between the two groups were statistically significant （P〈0.05）. Conclusion The use of two-piece urinary tract ostomy bag to collect exudate and to fix the drainage tube can remarkably reduce the irritation of bile to local skin, thereby improving the degree of comfort and the quality of life. Frequent daily dressing change is no more needed, which reduces the workload of health care workers and reduces the financial burden of patients as well, meanwhile, the measurement of drainage fluid volume can be more accurate.

关 键 词：舒适管理:经皮肝穿刺胆道引流 渗液 

分 类 号：R735.7[医药卫生—肿瘤]