Application of stepped drainage new model in nursing care for severe acute pancreatitis patients with necrosis and infection
10.3760/cma.j.issn.1674-2907.2019.10.016
- VernacularTitle:阶梯式引流新模式在重症急性胰腺炎坏死感染患者护理中的应用
- Author:
Fangzheng JIANG
1
;
Nan WU
;
Honglin YAO
;
Jingjing GE
;
Yangyang XUE
;
Lili WU
;
Xianghong YE
;
Zhihui TONG
;
Weiqin LI
Author Information
1. 解放军东部战区总医院普通外科,南京 210002
- Keywords:
? Severe acute pancreatitis;
? Infected pancreatic necrosis;
? Stepped drainage;
? Pertinent nursing
- From:
Chinese Journal of Modern Nursing
2019;25(10):1259-1262
- CountryChina
- Language:Chinese
-
Abstract:
Objective? To summarize the key content of nursing of stepped drainage new model for severe acute pancreatitis (SAP) patients with necrosis and infection. Methods? From January 2014 to December 2016, we selected 417 SAP patients with infected pancreatic necrosis (IPN) in General Surgery Intensive Care Unit at Nanjing General Hospital, People's Liberation Army. The "four-step" stepped drainage model was adopted during treatment including four stages, percutaneous catheter drainage, continuous negative pressure irrigation drainage, endoscopic drainage and laparotomy necrotic tissue debridement drainage. All stages of nursing had something in common and different emphasis points. Nursing care paid attention to strengthening the nursing for abdominal puncture catheter, abdominal double pipe, endoscopic operation cooperation and postoperative nursing of laparotomy. Results? Among 417 SAP patients with IPN, a total of 413 patients were with percutaneous catheter drainage and single patient was with one to seven drainage tubes, a total of 2 252 tubes; 315 patients were with abdominal double pipe irrigation drainage and single patient was with two to seven double pipes, a total of 1 386 double pipes; 186 patients were with endoscopic drainage and single patient was with two to five times of endoscopic necrotic tissue debridement, a total of 725 times; 91 patients were with laparotomy and single patient was with laparotomy one to three times. During nursing care, totals of 13 percutaneous drainage catheters and abdominal double pipes slipped off; 109 cases of poor drainage happened to double pipe drainage with 56 cases of obstructed drainage;there were 30 cases of folding, 7 cases of hemorrhage and 16 cases of shifting. Those problems were all found and handled timely with no consequence caused by poor drainage and improper nursing care. Conclusions? Among SAP patients with IPN, keys to guarantee high quality of nursing included mastering nursing emphasis of all stages, taking targeted nursing, keeping abdominal puncture catheter unobstructed, abdominal double pipes effectively sucking, cooperating on endoscopic necrotic tissue debridement and strengthening postoperative monitoring and wound management.
