CAJ | 학술논문

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5~10 cm,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P＜0．05).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.
탐토인류관대량삼루시사용일건식비뇨조구대적림상효과.방법채용편리추양법선택남방의과대학주강의원2011년3월지2013년7월행외과수술치료후발생인류관삼루적환자102례,채용수궤수자표법분성 A、B、C삼조,매조각34례,A조채용상규환약후복개무균사포재개의용무균면점；B조채용전단인류관보류5~10 cm,장인류관말단방치재일건식비뇨조구대중,조구대점첩재인류관구수집인류액화삼루액；C조채용일건식비뇨조구대점첩재인류관구수집삼액,조구대상전일개구,인류관말단종조구대개구천출후접일차성항반류뇨대.비교삼조환자적서괄도、만의도화주위피부자격성피염적발생솔이급환약시간、차수화비용.결과 B、C조환자재동통/불괄급초필/저상등방면적서괄도급만의도고우 A조,자격성피염적발생솔저우A조,환약시간、환약차수급환약비용저우A조；B조환약시간급환약비용우저우C조,차이균유통계학의의(균P＜0．05).결론응용일건식비뇨조구대처리인류관대량삼루능제고환자적서괄도화만의도,감소불량반응화환약차수등；차채용장전단적인류관말단방치재일건식비뇨조구대중적방법경능절성환약비용화환약시간,감경의생화호사적공작량.
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.