预防性结肠造口术后造口脱垂相关因素分析与护理对策  

Influencing factors and nursing countermeasures of stoma prolapse after prophylactic colostomy

作　　者：邹俭妹 方艳霞[1] 李娜[1] 文洁 苏施颖 ZOU Jianmei;FANG Yanxia;LI Na;WEN Jie;SU Shiying(Zhongshan People's Hospital,Zhongshan 528403,China)

机构地区：[1]中山市人民医院,广东省中山市528403

出　　处：《护理实践与研究》2024年第12期1826-1830,共5页Nursing Practice and Research

基　　金：中山市社会公益科技研究项目(编号:2022B1151)。

摘　　要：目的探讨影响预防性结肠造口术后患者造口脱垂的相关因素,寻找相应的预防性护理对策。方法采用回顾性调查,对中山市人民医院在2021年1月—2023年12月诊治的90例行预防性结肠造口术治疗患者进行资料分析,将其中术后30 d内出现造口脱垂情况的37例患者纳入病例组,以术后30 d内未出现造口脱垂情况的53例患者纳入对照组,采用单因素分析、多因素Logistic回归分析影响预防性结肠造口术后患者造口脱垂的相关因素,并提出相应的预防性护理对策,以此减少预防性结肠造口术后造口脱垂的发生率。结果多因素Logistic回归分析结果显示,造口直径、造口类型、高腹腔压力是预防性结肠造口术后患者造口脱垂的影响因素(P<0.05)。结论预防性结肠造口术后患者造口脱垂的发生与造口直径、造口类型以及高腹腔压力有关,其中造口直径越小,造口脱垂发生风险越高;且相对于双腔造口,单腔造口会增加造口脱垂风险;而当患者存在高腹腔压力时,可能会降低造口脱垂风险,因此,在护理工作中应持续优化术后护理流程,减少预防性结肠造口术后造口脱垂的发生率。Objective To explore the relevant factors affecting stoma prolapse in patients after prophylactic colostomy and to find corresponding preventive nursing countermeasures.Methods A retrospective survey was conducted to analyse the data of 90 cases of prophylactic colostomy patients treated in Zhongshan People's Hospital from January 2021 to December 2023,in which 37 patients who developed stoma prolapse within 30 days after surgery were included in the case group,and 53 patients who didn't had the stoma prolapse within 30 days after surgery were included in the control group,and the results were analysed using univariate analysis,multifactor analysis to explain the factors affecting stoma prolapse in patients after prophylactic colostomy,and proposed corresponding preventive care countermeasures to reduce the incidence of stoma prolapse after prophylactic colostomy.Results The results of multifactorial Logistic regression analysis showed that stoma diameter,stoma type,and high abdominal pressure were the influencing factors of stoma prolapse in patients after prophylactic colostomy(P<0.05).Conclusion The occurrence of stoma prolapse in patients after prophylactic colostomy is related to stoma diameter,stoma type,and high abdominal pressure,in which the smaller the stoma diameter,the higher the risk of stoma prolapse,and compared with double-lumen stoma,single-lumen stoma increases the risk of stoma prolapse;and when the patient exists a high abdominal pressure,which could reduce the risk of stoma prolapse,so the postoperative nursing process should be continually optimised in nursing care to reduce the incidence of stoma prolapse after prophylactic colostomy.

关 键 词：预防性结肠造口术 造口脱垂 造口直径 造口类型 高腹腔压力 护理对策 

分 类 号：R473.6[医药卫生—护理学]