造口底盘用于造口旁切口的效果评价
收稿日期: 2019-12-25
网络出版日期: 2022-07-28
基金资助
上海交通大学医学院附属瑞金医院护理科研基金项目(RJHK-2019-7);广慈卓越青年C计划(GCQN-2019-C10)
Evaluation of stoma skin barrier in peristomal wound healing
Received date: 2019-12-25
Online published: 2022-07-28
目的:分析造口底盘在造口旁切口治疗中的应用效果。方法:纳入2018年11月至2019年11月我院外科造口门诊60例造口与切口距离<底盘覆盖范围(10 cm×10 cm)的病人,随机分为研究组和对照组各30例。研究组使用造口底盘,对照组采用片状水胶体敷料治疗保护。评价两组病人治疗效果、舒适度、换药时间和成本效益的差异。结果:研究组和对照组回肠造口分别为23例、21例,结肠造口分别为7例、9例。研究组和对照组造口周围皮肤变色、侵蚀和组织增生的评分分别为(5.67±1.21)和(5.80±1.24),切口面积分别为(18.76±16.14) cm2和(20.91±15.39) cm2。两组病人7 d后治疗效果和舒适度比较,差异无统计学意义。但研究组的治疗成本低于对照组[(244.67±58.47)元比(341.43±106.13)元,P<0.001],换药时间亦少于对照组[(10.90±1.58) min比(14.77±3.42) min,P<0.001),差异均有显著统计学意义。结论:造口底盘可替代水胶体对造口旁切口进行治疗和保护,为造口旁切口治疗的方法之一。
乔祎, 李琛, 赵任, 奚蓓华 . 造口底盘用于造口旁切口的效果评价[J]. 外科理论与实践, 2021 , 26(01) : 72 -75 . DOI: 10.16139/j.1007-9610.2021.01.015
Objective To assess the effect of stoma skin barrier in the treatment of peristomal wound. Methods Sixty patients of intestinal stoma with less than 10 cm from wound in our peristomal skin care departments of surgery from November 2018 to November 2019 were enrolled. The cases were randomly divided into study group and control group each 30 cases. Stoma skin barrier was used to treat the cases in study group and hydrocolloid dressing to treat the cases in control group. The effect of treatment, satisfaction, dressing change time and cost-benefit were compared between two groups. Results Ileostomies were 23 cases in study group and 21 cases in control group. Colostomies were 7 cases in study group and 9 cases in control group. Scores of discoloration erosion, tissue overgrowth of peristoma were evaluated to be (5.67±1.21) in study group and (5.84±1.24) in control group. Would area was (18.76±16.14) cm2 to patients in study group and (20.91±15.39) cm2 in control group. There was no statistically significant difference in the effect and satisfaction after 7 days between two groups. However, treatment cost of study group was lower than that of control group[(244.67±58.47) yuan vs.(341.43±106.13) yuan, P<0.001], and dressing change time of study group was also less than that of control group[(10.90±1.58) min vs.(14.77±3.42) min, P<0.001]. There was significant difference in the two parameters between two groups. Conclusions Stoma skin barrier can be used to replace hydrocolloid dressing to care peristomal wound, which would be the strategy of peristomal wound healing.
Key words: Stoma skin barrier; Wound healing; Effect
| [1] | 云红, 张怡, 郑薇, 等. 预防性回肠造口术后粪水性皮炎的危险因素及护理对策[J]. 中华结直肠疾病电子杂志, 2019, 8(4):413-416. |
| [2] | Berndtsson IE, Lindholm E, Oresland T, et al. Health-related quality of life and pouch function in continent colostomy patients: a 30-year perspective[J]. Dis Colon Rectum, 2004, 47(12):2131-2137. |
| [3] | 吴昕, 林国乐, 肖毅, 等. 回肠造口与横结肠造口在经标本取出辅助切口行保护性肠造口术中应用的比较分析[J]. 中华胃肠外科杂志, 2019, 22(10):961-965. |
| [4] | Wada Y, Miyoshi N, Ohue M, et al. Comparison of surgical techniques for stoma closure: a retrospective study of purse-string skin closure versus conventional skin closure following ileostomy and colostomy reversal[J]. Mol Clin Oncol, 2015, 3(3):619-622. |
| [5] | 黎秋霞, 黄萍, 左红群. 水胶体敷料联合复方角菜酸酯乳膏对直肠癌造口术后周围性皮炎的护理观察[J]. 广西医科大学学报, 2015, 32(2):344-345. |
| [6] | 朱书芳, 高泽宇. 水胶体敷料处理缝合伤口痂皮的临床观察[J]. 中华损伤与修复杂志(电子版), 2016, 11(4):314-315. |
| [7] | 王文华, 韩晓梅, 姬响华, 等. 水胶体敷料对压疮合并中重度感染的临床疗效[J]. 中华医院感染学杂志, 2019, 29(6):949-952. |
| [8] | 雍秀伟. 基于微信平台的延续健康教育对直肠癌结肠造口患者自我护理能力及造口皮肤的影响[J]. 医学临床研究, 2019, 36(8):1663-1664,封3. |
| [9] | 张寅. 激光联合伤口保护膜及造口粉在失禁性皮炎中的疗效观察[J]. 蚌埠医学院学报, 2015, 40(12):1766-1767. |
| [10] | Ren C, Chi M, Zhang Y, et al. Dexmedetomidine in postoperative analgesia in patients undergoing hysterectomy: a CONSORT-prospective,randomized,controlled trial[J]. Medicine(Baltimore), 2015, 94(32):e1348. |
| [11] | 王冰洋, 牛广明, 杜华, 等. 不同敷料在糖尿病足溃疡伤口治疗中的研究与应用[J]. 中国组织工程研究, 2016, 20(34):5155-5162. |
| [12] | Steinhagen E, Colwell J, Cannon LM. Intestinal stomas postoperative stoma care and peristomal skin complications[J]. Clin Colon Rectal Surg, 2017, 30(3):184-192. |
| [13] | Klink CD, Lioupis K, Binnebösel M, et al. Diversion stoma after colorectal surgery: loop colostomy or ileostomy?[J]. Int J Colorectal Dis, 2011, 26(4):431-436. |
| [14] | Hosseinpour M, Fazeli A, Agabeigi M. Efficacy of acacia senegal for stoma care in children with colostomy[J]. Eur J Pediatr Surg, 2012, 22(3):234-237. |
| [15] | 姚宇锋, 孙红玲, 许彩云, 等. 负压封闭引流技术在胸骨术后切口脂肪液化中的应用[J]. 中华急诊医学杂志, 2018, 27(9):1060-1061. |
| [16] | 袁东亮, 赵耀华, 邓海涛, 等. 自制负压封闭引流装置在八例上肢深度烧伤患者腹部带蒂皮瓣术后固定及引流中的应用[J]. 中华烧伤杂志, 2019, 35(8):611-613. |
| [17] | Vassallo C, Bnmelli V, Zecca M, et al. Isomorphic cutaneous graft-versus-host disease reaction after ultraviolet exposur: clinical, histological and direct immunofluorescence studies of four allo-transplanted patients[J]. J Eur Acad Dennatol Venereol, 2009, 23(8):913-918. |
| [18] | 翁婵媛, 陈凌燕, 解艳红, 等. 水胶体敷料与聚维酮碘联合光照对压疮感染患者创面愈合的疗效[J]. 中华医院感染学杂志, 2018, 28(12):1839-1841,1855. |
| [19] | Nybaek H, Bang Knudsen D, Norgaard Laursen T, et al. Skin problems in ostomy patients: a case-control study of risk factors[J]. Acta Derm Venereol, 2009, 89(1):64-67. |
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