肝移植术后再次发生肠漏患者的护理
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摘要
目的总结肝移植术后再次发生肠漏患者的护理经验。方法对2例肝移植术后再次发生肠漏患者实施手术修复,护理措施包括术后严密的病情观察、引流液和腹部体征的观察,早期的营养支持,做好心理护理和健康教育。结果 2例肝移植术后再次发生肠漏患者,1例再次修复;另1例行末端回肠切除术和回肠造口术,并给予治疗和护理,均康复出院。结论术后严密的病情观察、引流液和腹部体征的观察,能及时发现肝移植术后再次肠漏的发生;早期营养支持对肠漏患者的康复起着重要的作用;做好心理护理和健康教育可提高患者治疗的信心。
Objective To summarize the experience in nursing patients with gut leak after liver transplantation. Methods Two patients with recurrent gut leakafter liver transplantation underwent surgical repair. The nursing measures included strict observation of postoperative disease, observation of drainage fluid and abdominal signs, early nutritional support, good psychological nursing and health education. Results Gut leak occurred in the two cases again after liver transplantation. One case was treated with repair again and the other with end-stage ileotomy and ileostomy. The patients were discharged after medication and nursing care.Conclusions The close postoperative observation of the disease, observation of drainage fluid and abdominal signs can prompt the discovery of intestinal re-perforation. The early nutritional support plays an important role in the rehabilitation of patients with gut leak after liver transplantation. Mental care and health education can enhance patient's confidence in treatment.
Objective To summarize the experience in nursing patients with gut leak after liver transplantation. Methods Two patients with recurrent gut leakafter liver transplantation underwent surgical repair. The nursing measures included strict observation of postoperative disease, observation of drainage fluid and abdominal signs, early nutritional support, good psychological nursing and health education. Results Gut leak occurred in the two cases again after liver transplantation. One case was treated with repair again and the other with end-stage ileotomy and ileostomy. The patients were discharged after medication and nursing care.Conclusions The close postoperative observation of the disease, observation of drainage fluid and abdominal signs can prompt the discovery of intestinal re-perforation. The early nutritional support plays an important role in the rehabilitation of patients with gut leak after liver transplantation. Mental care and health education can enhance patient's confidence in treatment.
引文
[1]田庆,张建军,郭庆军,等.肝移植术后早期并发消化道瘘临床分析[J].实用器官移植电子杂志,2013,1(5):286-289.
[2]豆秋江,罗新春,叶海丹,等.肝移植术后早期并发消化道瘘的护理[J].中国实用护理杂志,2012,28(16):1-3.
[3]豆秋江,叶海丹,廖苑,等.肝移植术后早期并发胃肠道瘘的营养支持及护理[J].护士进修杂志,2012,27(7):603-604.
[4]迟强.营养支持对消化道痔患者高代谢状态的作用[J].中华胃肠外科杂志,2012,15(5):440-441.
[5]PASERO C,MCCAFFERY M.Pain assessment and pharmacologic management[M].St.louis Missouri:Elsevier Health Sciences,2010:155-157.
[6]周健,鞠卫强,何晓顺,等.肝移植术后早期并发消化道瘘的临床特点和诊治分析.中华外科杂志,2012,50(3):222-225.
[7]胡宏鸯,魏惠燕,叶志弘.造口皮肤黏膜分离伴造口肠瘘患者的护理[J].中华护理杂志,2013,48(4):361-361.
[8]马驰,史炼钢,曲杨,等.结肠穿孔致急性腹膜炎病人术后营养支持的临床研究[J].肠外与肠内营养,2017,24(3):168-170.
[9]乔小平,张桂华,陈名林.肠穿孔腹腔感染肠造口术的应用研究[J].中华医院感染学杂志,2015,24(18):4243-4245.
[10]韦秀利.DET/AIM在肠造口术后周围皮肤护理中的应用[J].护士进修杂志,2015,29(15):1386-1388.
[2]豆秋江,罗新春,叶海丹,等.肝移植术后早期并发消化道瘘的护理[J].中国实用护理杂志,2012,28(16):1-3.
[3]豆秋江,叶海丹,廖苑,等.肝移植术后早期并发胃肠道瘘的营养支持及护理[J].护士进修杂志,2012,27(7):603-604.
[4]迟强.营养支持对消化道痔患者高代谢状态的作用[J].中华胃肠外科杂志,2012,15(5):440-441.
[5]PASERO C,MCCAFFERY M.Pain assessment and pharmacologic management[M].St.louis Missouri:Elsevier Health Sciences,2010:155-157.
[6]周健,鞠卫强,何晓顺,等.肝移植术后早期并发消化道瘘的临床特点和诊治分析.中华外科杂志,2012,50(3):222-225.
[7]胡宏鸯,魏惠燕,叶志弘.造口皮肤黏膜分离伴造口肠瘘患者的护理[J].中华护理杂志,2013,48(4):361-361.
[8]马驰,史炼钢,曲杨,等.结肠穿孔致急性腹膜炎病人术后营养支持的临床研究[J].肠外与肠内营养,2017,24(3):168-170.
[9]乔小平,张桂华,陈名林.肠穿孔腹腔感染肠造口术的应用研究[J].中华医院感染学杂志,2015,24(18):4243-4245.
[10]韦秀利.DET/AIM在肠造口术后周围皮肤护理中的应用[J].护士进修杂志,2015,29(15):1386-1388.