刘燕+黄幼平+梁小明+蔡芳芳+陈志颜++黄燕玲

[摘要]目的 探讨自制大便收集套件联合间歇冲洗和负压吸引在大便失禁患者中的应用效果。方法 选取2015年1月～2017年2月我院收治的80例大便失禁患者作为研究对象，采用随机数字表法分为两组，每组40例。观察组采用自制大便收集套件联合间歇冲洗和负压吸引收集大便，对照组采用造口袋负压吸引收集大便。比较两组患者造口袋渗漏次数、更换造口袋次數、更换造口袋所需护理人员人数、病人舒适度等指标。结果 观察组患者的造口袋渗漏次数、更换造口袋次数显著低于对照组，观察组更换造口袋所需的护理人员人数少于对照组，病人舒适度高于对照组，差异均有统计学意义（P<0.05）。结论 自制大便收集套件联合间歇冲洗和负压吸引能够有效减少造口袋渗漏和更换次数，减轻护理工作量。该自制套件，取材方便，制作简单，易操作，值得推广应用。

[关键词]造口袋；间歇冲洗；负压吸引；大便失禁

[中图分类号] R473.75 [文献标识码] A [文章编号] 1674-4721（2017）09（a）-0017-03

Effect observation of ostomy bag combined with intermittent irrigation and negative pressure suction in fecal incontinence patients

LIU Yan HUANG You-ping LIANG Xiao-ming CAI Fang-fang CHEN Zhi-yan HUANG Yan-ling

Intensive Care Unit，the Fifth People′s Hospital of Foshan City，Guangdong Province，Foshan 528211，China

[Abstract] Objective To investigate the effect of self-made fecal collection kits combined with intermittent irrigation and negative pressure suction in fecal incontinence patients.Methods A total of 80 fecal incontinence patients treated in our hospital from January 2015 to February 2017 were selected as research objects in this study.All of the patients were divided into observation group and control group according to the random number table method，with 40 cases in each group.The feces of the observation group were collected with a self-made fecal collection kits combined with intermittent irrigation and negative pressure suction.The feces of the control group were collected with a self-made ostomy bag combined with negative pressure suction.The leakage times and replacement times of ostomy bag，the number of nursing staff needed to replace ostomy bag and the comfort degree of the patients in the two groups were compared.Results Leakage times and replacement times of ostomy bag in the observation group were significantly lower than those in the control group；the number of nursing staff needed to replace ostomy bag was less in the observation group than in the control group；the patient was more comfortable than the control group，and the differences were statistically significant （P<0.05）.Conclusion The self-made fecal collection kits combined with intermittent irrigation and negative pressure suction can effectively can reduce the leakage of the ostomy bag and the frequency of replacement，and reduce the nursing workload.The self-made fecal collection kits have the advantages of simple manufacture，convenient material drawing and convenient operation，and is worthy of clinical application.endprint

[Key words]Ostomy bag；Intermittent irrigation；Negative pressure suction；Fecal incontinence

大便失禁属于排便功能紊乱的一种，主要是由于肛门括约肌及其相关神经受损，导致患者失去对粪便和气体的控制能力[1-2]。大便失禁易引起各种并发症，不仅增加患者痛苦，引起心理障碍，还会增加家属以及医护人员的护理难度[3-4]。造口袋临床常用于大便失禁患者的护理，能够有效减少各种并发症[5-6]。ICU患者多病情危重，伴神经功能紊乱，且长期使用抗生素引起肠道菌群失调，大便和产气量多，故而需频繁排放造口袋内的大便和气体，否则易导致造口袋膨胀、爆破，反复清洁肛周皮肤，频繁更换造口袋，不仅增加了护理工作量还影响护理效果[7-9]。……