造口袋局部剪裁技巧联合防漏贴环在肠造口旁瘘门诊患儿的应用效果

目的探讨造口袋剪裁技巧联合防漏贴环在肠造口术后并发造口旁瘘伴刺激性皮炎门诊患儿的应用效果。方法采用便利抽样法,选取2017年5月—2019年11月于深圳市儿童医院造口专科护理门诊就诊的肠造口术后并发造口旁瘘伴刺激性皮炎的家庭护理困难患儿21例为研究对象,使用造口袋剪裁技巧(旁瘘处局部微扩增宽1~2 mm剪裁)联合防漏贴环方法进行干预,比较干预前后肠造口周围皮肤状况评分(DET)、造口袋更换间隔时间、主要照护者SAS得分。结果21例患儿首次就诊时DET评分为(8.29±1.15)分,干预1周后复诊时DET评分为(5.14±1.80)分,差异有统计学意义(t=11.65,P<0.01)。干预前造口袋更换间隔时间为(0.45±0.10)d,干预后更换间隔时间为(1.06±0.29)d,差异有统计学意义(t=-10.67,P<0.01)。首次就诊时21例患儿的主要照护者SAS评分为(66.05±5.29)分,干预1周后SAS评分(49.10±3.35)分,差异有统计学意义(t=21.59,P<0.01)。结论肠造口术后并发造口旁瘘伴刺激性皮炎的家庭护理困难患儿使用造口袋局部剪裁技巧联合防漏贴环可缩小刺激性皮炎的范围,减轻刺激性皮炎的严重程度,延长造口袋更换间隔时间,有效改善主要照护者的焦虑症状。

Application effect of local tailoring technique of stoma bag combined with leak-proof tape ring in outpatient children with intestinal parastomal fistula

Objective To explore the application effect of ostoma bag tailoring techniques combined with leak-proof tape ring in outpatients children with parastomal fistula and irritant dermatitis after enterostomy.Methods Using the convenient sampling method,a total of 21 children with home care difficulties after enterostomy complicated with parastomal fistula and irritant dermatitis who visited the stoma specialist nursing clinic of Shenzhen Children's Hospital from May 2017 to November 2019 were selected as the research objects.Ostoma bag tailoring techniques(partial fistulas were slightly enlarged and tailored with a width of 1 to 2 mm)combined with leak-proof tape ring were used for intervention.Discoloration,Erosion and Tissue Overgrowth(DET)score,the interval between stoma bag replacement and SAS score of the main caregivers were compared before and after intervention.Results DET score of 21 children at the first visit was(8.29±1.15),and the DET score at the return visit after 1 week of intervention was(5.14±1.80),and the difference was statistically significant(t=11.65,P<0.01).The interval between replacement of stoma bag before intervention was(0.45±0.10)d,and the interval of replacement after intervention was(1.06±0.29)d,and the difference was statistically significant(t=-10.67,P<0.01).The SAS score of main caregivers of 21 children at the first visit was(66.05±5.29),and the SAS score after 1 week of intervention was(49.10±3.35),and the difference was statistically significant(t=21.59,P<0.01).Conclusions For children with home care difficulties complicated with parastomal fistula and irritant dermatitis after enterostomy,the use of local tailoring technique of stoma bag combined with leak-proof tape ring can reduce the scope of irritant dermatitis,reduce the severity of irritant dermatitis,prolong interval between replacement of stoma bag and effectively improve the anxiety symptoms of main caregivers.