This article summarized the nursing experience of multiple gastrointestinal fistulas after operation in a patient with acute hemorrhagic necrotizing enteritis and septic shock. The patients had severe postoperative infections,poor nutritional status,multiple incisions and fistulas with close location and large excretion. Multi-disciplinary joint evaluation,diagnosis and treatment were conducted. Nursing measures included implementing empirical combined antibiotic therapy according to multiple drug-resistant bacterial infections with different strains,dynamic adjustment of total intravenous nutrition formula,inhibition of digestive juice secretion,psychological support and etc. And nurses used vacuum sealing drainage technology,separated the areas of incisions and fistulas for management,selected appropriate ostomy bags to effectively collect fistula excrement and avoid leakage,to promote the healing of the incision. The patient's infection was controlled 30 days after the operation,the abdominal incision was healed,and the fistula functioned well. The patient can take care of himself 4 months after the operation,which laid the foundation for the later treatment.
WANG Qunmin
,
WANG Qin
,
WANG Feixia
,
WU Guosheng
,
LIU Chaoxu
. Nursing care of multiple gastrointestinal fistulas after operation in a patient with acute hemorrhagic necrotizing enteritis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022
, 3(2)
: 183
-186
.
DOI: 10.3761/j.issn.2096-7446.2022.02.018
[1] 李文利,纪莉莎,钮自宇,等. 内镜在成人急性出血性坏死性小肠炎诊治中的应用[J]. 中国临床医生杂志,2019,47(10):1258-1260.
Li WL,Ji LS,Niu ZY,et al.Application of endoscopy in diagnosis and treatment of adult acute hemorrhagic necrotizing enterocolitis[J]. Chin J Clin,2019,47(10):1258-1260.
[2] Zeng SX,Tsia Hin Fong CJ,Li LJ,et al. Acute hemorrhagic necrotizing enteritis:a case report and review of the literature[J]. Ann Palliat Med,2021,10(5):5853-5861.
[3] 赵孝开,娄季鹤,冯新献,等. 严重烧伤并发急性出血坏死性肠炎和真菌感染一例[J]. 中华烧伤杂志,2018,34(8):562-563.
Zhao XK,Lou JH,Feng XX,et al.One case of severely burned patient complicated by acute hemorrhagic necrotizing enteritis and fungal infection[J]. Chin J Burn,2018,34(8):562-563.
[4] 李鑫,刘绍,关纯,等. 尼曼-匹克病合并创伤性硬脑膜外血肿患儿的护理[J]. 中华急危重症护理杂志,2021,2(1):90-93.
Li X,Liu S,Guan C,et al.Nursing care of a child with Niemann-Pick disease complicated with traumatic epidural hematoma[J]. Chin J Emerg Crit Care Nurs,2021,2(1):90-93.
[5] 石芸,郑亚萍,郦艳,等. 单手双腔同时封管在预防PICC堵管中的应用[J]. 中华护理杂志,2017,52(2):621-623.
Shi Y,Zheng YP,Li Y,et al.Application of one-hand double-lumen simultaneous locking technique in the prevention of occlusion using high pressure resistant double-lumen PICCs[J]. Chin J Nurs,2017,52(2):621-623.
[6] 廖苑,黄婉琳,李向芝,等. 1例亲体小肠移植术患者的营养支持与护理[J]. 中华护理杂志,2006,41(5):411-413.
Liao Y,Huang WL,Li XZ,et al.Alimentotherapy and nursing of a patient undergoing living-related small bowel transplantation[J]. Chin J Nurs,2006,41(5):411-413.
