一件式泌尿造口袋应用于引流管大量渗漏的临床效果

目的探讨引流管大量渗漏时使用一件式泌尿造口袋的临床效果。方法采用便利抽样法选择南方医科大学珠江医院2011年3月至2013年7月行外科手术治疗后发生引流管渗漏的患者102例,采用随机数字表法分成A、B、C三组,每组各34例,A组采用常规换药后覆盖无菌纱布再盖医用无菌棉垫;B组采用剪短引流管保留5~10cm,将引流管末端放置在一件式泌尿造口袋中,造口袋粘贴在引流管口收集引流液和渗漏液;C组采用一件式泌尿造口袋粘贴在引流管口收集渗液,造口袋上剪一开口,引流管末端从造口袋开口穿出后接一次性抗反流尿袋。比较三组患者的舒适度、满意度和周围皮肤刺激性皮炎的发生率以及换药时间、次数和费用。结果 B、C组患者在疼痛/不适及焦虑/沮丧等方面的舒适度及满意度高于A组,刺激性皮炎的发生率低于A组,换药时间、换药次数及换药费用低于A组;B组换药时间及换药费用又低于C组,差异均有统计学意义(均P0.05)。结论应用一件式泌尿造口袋处理引流管大量渗漏能提高患者的舒适度和满意度,减少不良反应和换药次数等;且采用将剪短的引流管末端放置在一件式泌尿造口袋中的方法更能节省换药费用和换药时间,减轻医生和护士的工作量。

Clinical Investigation of Using One-Piece Urostomy Pouch for Heavy Leakage of Drainage Tube

Objective To discuss the clinical effect of using one-piece urostomy pouch for heavey leakage of drainage tube.Methods By convenience sampling,102 cases were selected and randomly divided into group A,B and C with 34 patients in each group.The patients in group A were treated with conventional methods by covering sterile gauze and medical sterile pad after changing dressing;the patients in group B were trea-ted by placing 5～10 cm of the drainage tube end in one-piece urostomy pouch attached for collecting the drainage fluid and leachate;the patients in group C were treated by placing the drainage tube end in one-piece urostomy pouch attached,and an opening on the pouch was made.Then an anti-reflux urine bag was connected with the drainage tube outstretching from the opening of the pouch.Three different treatments were compared by patient comfortable level,satisfaction,the incidence of dermatitis in the skin surround-ing,dressing time,dressing frequency and dressing costs.Results The comfort and satisfaction in group B and C was significantly higher than group A;the incidence of irritant dermatitis in group B and group C was significantly lower than group A ;the dressing frequency,dressing time and dressing cost in group B and C was significantly less than group A.The dressing time and dressing cost in group B was significantly less than group C （P〈0.05）.Conclusion Application of one-piece urostomy pouch to deal with heavey leakage of drainage tube can improve the patient comfort level and satisfaction rate and reduce adverse reactions and times of dressing.Putting the end of bobbed drainage tube in the one-piece urostomy pouch could save the patients’medical costs and dressing time and reduce doctors’and nurses’workload.