伤口内镜在1例Miles术后结肠造口坏死合并造口皮肤黏膜分离患者中的应用  

Application of wound endoscopy in a case of colostomy necrosis combined with skin and mucosa separation after Miles operation

作　　者：朱小妹[1] 余志勇 韦迪[1] 罗竞平[1] 谌永毅[1] 刘华云[1] 陈玉盘[1] ZHU Xiaomei;YU Zhiyong;WEI Di;LUO Jingping;CHEN Yongyi;LIU Huayun;CHEN Yupan(Stoma Wound Incontinence Care Center,Hunan Cancer Hospital,Hunan Province,Changsha 410013,China)

机构地区：[1]湖南省肿瘤医院造口伤口失禁护理中心,湖南长沙410013

出　　处：《中国当代医药》2024年第1期135-139,共5页China Modern Medicine

基　　金：湖南省科技创新计划项目(2021SK51113);湖南省中医药科研计划项目(E2022041);湖南省卫生健康委科研计划项目(20201628);湖南创新型省份建设专项项目(2023JJ60034)。

摘　　要：肠造口术是外科常见施行的手术之一,往往是挽救生命、延续生命和改善生活质量的重要手段。而肠造口坏死是由造口血供不足引起的一种术后早期并发症。肠造口坏死会造成造口恢复延迟,严重者需要手术处理,会加大治疗和护理的难度。本文总结1例伤口内镜在造口黏膜缺血坏死合并造口皮肤黏膜分离患者中的应用效果。要点包括早期使用伤口内镜准确评估造口黏膜缺血坏死深度、使用造口护肤粉处理造口黏膜缺血、联合凸面底盘及腰带抬高造口皮肤黏膜等,同时关注患者营养,心理、家庭社会支持,加强健康教育和基础护理。经过14d的综合性护理,患者坏死的造口黏膜自溶性脱落,黏膜分离创面基本愈合,患者及家属逐渐了解疾病相关知识,并基本掌握造口护理技巧、患者也能够面对自己的造口并能积极配合及参与造口护理。Enterostomy is one of the common surgical operations,which is often an important means to save life,prolong life and improve the quality of life.Enterostomy necrosis is an early postoperative complication caused by insufficient blood supply.Enterostomy necrosis may delay the recovery of the stomy,and in severe cases require surgical management,which will increase the difficulty of treatment and nursing.This article summarized the application effect of wound endoscopy in a case of patient with ischemic necrosis of stoma mucosa combined with separation of stoma skin mucosa.Key points include accurate evaluation of the depth of ischemia and necrosis of the stoma mucosa with wound endoscopy at an early stage,treat-ment of stoma mucosa ischemia with stoma skin care powder,elevation of the stoma skin mucosa with a raised chassis and belt,etc.At the same time,attention should be paid to patient's nutrition,psychology,family and social support,and strengthening health education and basic nursing.Affer 14 days of comprehensive nursing,the patient's necrotic stoma mu-cosa autolysis and mucosal separation wound were basically healed.The patient and his family gradually understood the rel-evant knowledge of the disease and basically mastered the skills of stoma nursing.The patient was also able to face his own stoma and actively cooperate with and participate in the stoma nursing.

关 键 词：伤口内镜 造口 造口护肤粉 缺血坏死 皮肤黏膜分离 护理 

分 类 号：R735.37[医药卫生—肿瘤]