一件式造口袋的设计及在胆道闭锁婴儿腹腔引流中的应用

目的 设计一件式造口袋,应用于胆道闭锁婴儿的腹腔引流,并评价其效果。 方法 一件式造口袋由超薄敷料、普通一件式造口袋组成。选取2018年1月—2020年12月于北京市某三级甲等医院普外科收治的79例胆道闭锁婴儿作为研究对象,按住院时间,2020年1月—12月的20例胆道闭锁婴儿为试验组,将一件式造口袋应用于腹腔引流;2018年1月—2019年12月的59例胆道闭锁婴儿作为对照组,采用传统方纱换药的方式对腹腔引流管进行护理。比较两组每周换药次数、换药费用,浸渍性皮炎发生率、引流管脱落情况的差异。 结果 留置腹腔引流管期间,试验组平均每周中位换药次数较对照组少1.3次（P<0.001）,平均每周中位换药费用较对照组多46.1元（P=0.002）;浸渍性皮炎发生率为5%,低于对照组的22%,两组比较,差异无统计学意义（P=0.102）;试验组无引流管脱落发生,对照组2例发生引流管脱落。 结论 胆道闭锁婴儿腹腔引流中使用一件式造口袋可减少换药次数,降低浸渍性皮炎的发生率,腹水引流量计算更准确,临床护理效果良好。

The design and application of one-piece bag in abdominal drainage of infants with biliary atresia

Objective To design a modified one-piece ostomy bag used for abdominal drainage tube nursing in post-Kasai biliary atresia infants,and to assess its clinical application effects. Methods The modified one-piece ostomy bag consisted of an extra thin hydroactive dressing and a one-piece ostomy bag. From January,2018 to December,2020,all 79 post-Kasai biliary atresia patients were chosen. According to admission date,patients were divided into 2 groups. From January,2020 to December,2020,20 infants in the experimental group received modified one-piece ostomy bag nursing for abdominal drainage tube;from January,2018 to December 2019,59 patients in the control group received common dressing change nursing for abdominal drainage tube. The dressing change counts,costs,incidence of dermatitis and tube dislocation were compared between the 2 groups,and clinical nursing effects were observed. Results During abdominal drainage carriage,compared with it in the control group,the median counts of dressing change in experimental group were 1.4 counts less（P<0.001） and costs were ￥46.1 higher（P=0.002）,and the incidences of dermatitis were lower in the experimental group（5% vs. 22%,P=0.102）. There were no unexpected drainage tube dislocation in the experimental group,and 2 cases in the control group. Conclusion The clinical use of modified one-piece ostomy bag for abdominal drainage tube nursing in post-Kasai biliary atresia infants are feasible,which can reduce counts of dressing change and the incidence of dermatitis,with precise measurement of drained ascites volume.