雒胜男 唐春燕 巩树梅

[摘要] 目的 探讨可塑防漏贴环对肠造口患儿的影响。 方法 选择2016年11月～2017年10月于上海交通大学附属新华医院肠造口患儿80例，依据治疗措施不同进行分组，对照组[常规的正确的造口产品更换流程（ARC）]40例和观察组（常规的ARC更换流程+可塑防漏贴环）40例。观察两组患儿造口袋更换时间、造口袋更换间隔时间情况，观察两组患儿护理前、护理后发育商（DQ）评分、造口周围皮肤评分情况，观察两组患儿造口周围皮炎的发生情况。 结果 观察组患儿造口袋更换时间短于对照组，造口袋更换间隔时间长于对照组，差异有统计学意义（P < 0.05）。护理前两组患儿DQ评分、造口周围皮肤评分比较，差异无统计学意义（P > 0.05）;护理后对照组和观察组患儿DQ评分高于护理前，造口周围皮肤评分低于护理前，观察组患儿护理后DQ评分高于对照组，造口周围皮肤评分低于对照组，差异有统计学意义（P < 0.05）。观察组患儿造口周围皮炎的发生情况优于对照组，差异有统计学意义（P < 0.05）。 结论 可塑防漏贴环在肠造口患儿应用，可以提高造口袋应用效率和发育商，改善造口周围皮肤评分，降低造口周围皮炎发生率，值得临床推广应用。

[关键词] 可塑防漏贴环;肠造口;发育商;造口周围皮肤;造口周围皮炎

[中图分类号] R47          [文献标识码] A          [文章編号] 1673-7210（2019）03（a）-0173-04

[Abstract] Objective To approach the influence of plastic leak mount on colostomy children. Methods From November 2016 to October 2017， in Xinhua Hospital Affiliated to Shanghai Jiaotong University， 80 colostomy children were selected. They were divided into two groups by different treatment method， control group （regular ARC replacement process） 40 cases and detection group （regular ARC replacement process+plastic leak mount） 40 cases. The colostomy pocket replacement time， colostomy pocket replacement interval time of two group were detected， the DQ score， around colostomy skin score of two group before and after nursing were detected， the around colostomy dermatitis occurrence of two groups were detected. Results The colostomy pocket replacement time of detection group was shorter than control group， and the colostomy pocket replacement interval time was longer than control group， the differences were statistically significant （P < 0.05）. The DQ scores， around colostomy skin scores before nursing of two group were compared， the differences were not statistically significant （P > 0.05）， after nursing， the DQ scores of control group and detection group were higher than before nursing， the around colostomy skin scores was lower than before nursing， the DQ scores of detection group after nursing was higher than control group， the around colostomy skin score was lower than control group， the differences were statistically significant （P < 0.05）. The around colostomy dermatitis occurrence of detection group was better than control group， the difference was statistically significant （P < 0.05）. Conclusion The application of plastic leak mount on colostomy children， it can increase application efficiency of colostomy pocket and DQ，improve around colostomy skin score， decrease around colostomy dermatitis rate， and it is worth to be used.

[Key words] Plastic leak mount; Colostomy; DQ; Around colostomy skin; Around colostomy dermatitis

手术是儿科常用的手术方式，其是治疗肛肠先天畸形、结肠坏死合并休克和腹腔内感染的常用方法。小儿肠造口和成年患者肠造口有一定的区别，主要是其在肠造口术后3～6个月，临床症状消失后给予造口闭合术，而非永久性肠造口[1-2]。但是在手术过程中，患儿由于年龄较小，临床治疗依从性差，加上皮膚细嫩、免疫能力弱等原因，造成肠造口周围皮炎等各项并发症发生率明显升高，同时容易发生造口周围皮肤的红肿、溃烂等，严重影响患儿的生长发育和生活质量[3-4]。……