使用EN控制排粪在肛周脓肿术后负压治疗中的护理效果评价  

Use of enteral nutrition to delay bowel movement for negative pressure wound therapy after perianal abscess surgery

作　　者：黄琴[1] 郑帆[1] 王沙[1] 徐征[1] 刘红[1] 李丹[1] 王雪 陈娅 Huang Qin;Zheng Fan;Wang Sha;Xu Zheng;Liu Hong;Li Dan;Wang Xue;Chen Ya(Department of Anorectal Disease,People’s Hospital of Deyang City,Deyang 618000,Sichuan,China)

机构地区：[1]德阳市人民医院肛肠科,四川德阳618000

出　　处：《结直肠肛门外科》2021年第1期86-90,共5页Journal of Colorectal & Anal Surgery

基　　金：德阳市科技局项目(2017SZ017)。

摘　　要：目的评价使用肠内营养粉(EN)控制排粪在肛周脓肿术后伤口行负压治疗(NPWT)患者中的护理效果。方法纳入2016年1月至2019年2月在我院接受手术治疗的104例高位肛周脓肿患者为研究对象,随机分入NPWT+常规饮食组(n=52,采用脓肿切开引流术+NPWT治疗+常规饮食)及NPWT+EN组(n=52,采用脓肿切开引流术+NPWT治疗+EN)。比较两组伤口一般情况(伤口渗液量、渗液pH值、脓腔内口深度)、排粪情况、换药情况、疼痛程度(安静休息、排粪及换药时的疼痛程度)、伤口愈合时间、便秘发生率、总住院时间及总住院费用情况。结果术后7天内与术后第8~14天,两组的伤口渗液量、渗液pH值比较差异均无统计学意义(均P>0.05);术后第7、14天的脓腔内口深度比较差异均无统计学意义(均P>0.05)。NPWT+EN组的首次排粪时间晚于NPWT+常规饮食组,总排粪次数和总换药次数少于NPWT+常规饮食组,术后7天内的排粪次数和换药次数少于NPWT+常规饮食组,差异均有统计学意义(均P<0.05);两组术后第8~14天的排粪次数和换药次数比较差异均无统计学意义(均P>0.05)。NPWT+EN组伤口愈合时间、总住院时间短于NPWT+常规饮食组,总住院费用少于NPWT+常规饮食组,差异均有统计学意义(均P<0.05);两组便秘发生率比较差异无统计学意义(P>0.05)。结论使用EN控制排粪在肛周脓肿术后伤口行NPWT的护理中可取得较好的效果,具有一定的临床推广价值。Objectives To investigate the effect of use of enteral nutrition(EN)to delay bowel movement for negative pressure wound therapy(NPWT)after perianal abscess surgery.Methods One hundred and four patients with high perianal abscess treated in our hospital between January 2016 and February 2019 were recruited.Patients were randomly assigned to Group A(receiving abscess incision and drainage,NPWT,and routine dietary intake,n=52)and Group B(receiving abscess incision and drainage,NPWT,and EN,n=52).Wound evaluation(wound oozing,pH of exudate,and depth of internal abscess orifice),bowel movement,changes of wound dressing,pain at resting/bowel movement/change of dressing,time to wound healing,incidence of constipation,duration of hospitalization,and total expenses of hospitalization were compared between the two groups.Results The two groups did not differ in the amount of wound oozing and pH of exudate within 7 and 8~14 days after surgery(P>0.05).The depth of internal abscess orifice at 7 and 14 days postoperative was also similar between the two groups(P>0.05).Group B had significantly shorter time to first bowel movement,fewer total number of bowel movements and changes of wound dressing,fewer bowel movements,and changes of wound dressing within 7 days after surgery(P<0.05).The number of bowel movements and changes of wound dressing during 8~14 days days after surgery were similar between the two groups(P>0.05).Group B had significantly shorter time to wound healing,shorter hospitalization duration,and less hospitalization expense than Group A(P<0.05).The incidence of constipation was similar between the two groups(P>0.05).Conclusion Using EN to delay bowel movement is effective in NPWT after perianal abscess surgery.It has the potential for broader clinical use.

关 键 词：肛周脓肿 肠内营养粉 创面负压治疗技术 术后护理 

分 类 号：R473.6[医药卫生—护理学]