摘要
目的：观察和探讨消化液收集与肠内营养液混合回输治疗肠外瘘的应用及护理效果。方法：选取2019年2月到2020年1月对来我院接受治疗的早中期肠外瘘64例患者随机分为对照组与实验组两组。其中实验组患者建立回输通道以及消化液引流，回输收集消化液，搭配肠内营养进行护理，对照组采用常规护理。观察两组患者在得到护理后取得的临床效果以及并发症发生情况。结果：实验组32例患者当中没有出现死亡案例，仅有4例进行手术，2例为胃空肠吻合口瘘，另2例为十二指肠残端瘘，4例并发症患者均在手术后3个月内治愈，其余28例患者在一个月内无需通过手术自愈；有8例患者在病症早期出现了不良反应如恶心、腹胀以及腹泻等，没有出现其他严重的并发症。对照组患者则有16例患者无手术自愈，而另16例患者需再次手术。10例患者出现不良反应。此外，实验组伤口愈合时间显著短于对照组。结论：通过对高位肠外瘘患者采用肠液回输的治疗方法能够显著改善其吸收肠内营养物质的效果，加速患者康复，同时开展有效的护理对生理造成的干扰小，在临床上值得推广应用。
关键词： 消化液；肠内营养液；肠外瘘；护理
Abstract
Objective: To observe and discuss the application and nursing effect of digestive juice collection mixed with enteral nutrient solution in the treatment of parenteral fistula. Methods: From February 2019 to January 2020, 64 cases of mild/moderate parenteral fistula receiving treatment in our hospital were divided into the treatment group and the control group. The back passage and drainage of digestive fluid was used in treatment group and normal nursing was used in control group. Then the digestive fluid was collected through back infusion and nursing with enteral nutrition, so as to observe the clinical effect of the patients after nursing and the occurrence of complications. Results: Among the 32 patients in treatment group, there were no death cases, and only 4 patients were operated on, including 2 patients with gastric jejunal anastomotic fistula and 2 patient with duodenal stump fistula. Both patients were cured within 3 months after the operation, while the remaining 28 patients did not need surgery to heal them within a month. In four cases, adverse reactions such as nausea, abdominal distension and diarrhea occurred in the early stages of the disease, without other serious complications. In control group, only 16 cases recovered without additional surgery and 10 cases showed side effects. The wound recovery duration was also remarkably shorter in the test group than the control. Conclusion : The treatment of high parenteral fistula patients with intestinal fluid transfusion can significantly improve the effect of absorption of enteral nutrients, while carrying out effective nursing caused less interference to physiology, it is worthy of promotion and application in clinical practice.
Key words： Digestive juice; Enteral nutrient solution; Intestinal fistula; Nursing
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