营养支持结合功能锻炼治疗术后肠瘘的疗效观察与护理  

Observation and nursing of the effect of nutrition support combined with functional exercise in the treatment of postoperative intestinal fistula

作　　者：肖美萍 陈学洪[2] 黎衍香 Xiao Mei-ping;Chen Xue-hong;Li Yan-xiang(Department of Gastrointestinal Surgery, Ganzhou Hospital, Nanchang University, Ganzhou People's Hospital, Ganzhou, Jiangxi,341000, China;College of Medicine, Gannan Medical College, Ganzhou, Jiangxi, 341000, China)

机构地区：[1]江西省赣州市人民医院南昌大学附属赣州医院胃肠外科,江西赣州341000 [2]江西赣南医学院基础学院,江西赣州341000

出　　处：《当代医学》2017年第36期4-6,共3页Contemporary Medicine

基　　金：江西赣州市科技局计划课题项目(GZ2014ZSF157)

摘　　要：目的探讨应用肠内外营养支持结合功能锻炼治疗胃肠道疾病术后并发肠瘘的疗效及护理方法。方法对39例胃肠道疾病术后并发肠瘘患者采用腹腔双套持续冲洗引流,当肠瘘发生在肠道功能未恢复时,给予完全胃肠外营养,当瘘口控制、无腹腔感染、肠功能恢复逐步过渡肠内营养,同时结合循序渐进的功能锻炼,并加强腹腔双套管的护理、营养支持监护及功能锻炼指导。结果 39例肠瘘患者有效控制感染、纠正营养不良、提高抗病能力、体质量增加、瘘口愈合,痊愈出院,2例患者术后同时并发肝脓肿经多次住院反复治疗瘘口愈合,1例小肠系膜扭转。结论对胃肠道疾病术后并发肠瘘患者采用腹腔双套管持续冲洗、肠内外营养支持结合功能锻炼治疗及护理,疗效满意。Objective To investigate the curative effect and nursing of patients with intestinal fistula after enteral nutrition support and functional exercise in the treatment of gastrointestinal diseases.Methods Thirty-nine patients with gastrointestinal tract disease complicated with intestinal fistula were treated with two sets of continuous peritoneal irrigation and drainage.When intestinal fistula occurred without recovery of intestinal function,complete parenteral nutrition was given.When the fistula was controlled and no intra-abdominal infection was found,Intestinal function recovery gradually transition enteral nutrition,combined with step-by-step functional exercise,and strengthen the double peritoneal cannula care,nutrition support and functional training guidance.Results39cases of intestinal fistula patients effectively control infection,correct malnutrition,improve disease resistance,weight gain,fistula healed,cured and discharged,two patients with concurrent liver abscess after multiple hospitalized repeated fistula healing,1case small mesentery reversed.Conclusion The patients with gastrointestinal diseases complicated with intestinal fistula were treated with continuous double peritoneal lavage irrigation,enteral and external nutritional support combined with functional exercise therapy and nursing,the curative effect was satisfactory.

关 键 词：肠内外营养支持 护理 双套管持续冲洗 功能锻炼治疗 感染 

分 类 号：R473.6[医药卫生—护理学]