1例腹部伤口全层裂开患者经空肠造口行肠内营养的护理

总结1例腹部切口全层裂开患者经空肠造口行肠内营养的护理。护理要点：积极进行全身抗感染治疗,动态评估伤口,负压冲洗引流渗液;造口及周围皮肤管理,预防潮湿相关性皮炎;全程营养风险评估,经空肠造口行肠内营养;采用多模式镇痛,减轻患者疼痛症状;开展阶段性心理干预,正性引导患者认识疾病;制订出院指导手册,坚持全程随访计划。经91 d精心治疗与护理患者伤口完全愈合,居家期间完全肠内营养,营养状况良好,行造口还纳术,效果显著,患者满意。

Nursing care of a patient with full-thickness abdominal wound dehiscence undergoing enteral nutrition through jejunostomy

To summarise the care of a patient with a full abdominal incisional laceration who underwent enteral nutrition through jejunostomy. The key points of care included active fight against infection and intravenous hyper-nutrient therapy;dynamic assessment of the wound,negative pressure flushing to drain the exudate;stoma and surrounding skin management to prevent moist dermatitis;whole-course nutritional risk assessment and enteral nutrition through jejunostomy;multi-modal analgesia to reduce the pain symptoms of the patient;stage psychological intervention to positively guide the patient’s understanding of the disease; formulation of a discharge instruction manual and adherence to the full follow-up plan. After 91 days,the wound of the patient healed completely,during which the patient was given total enteral nutrition during the household period with good nutritional condition. The intestinal rejection was performed with good effects and patient satisfaction.