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    论普外科护理中引流护理重要性

    出处:论文网
    时间:2019-09-11

    论普外科护理中引流护理重要性

      【中图分类号】R775 【文献标识码】A 【文章编号】1005-0019(2019)15--01

      引言:在当前的临床治疗中,受到各类因素的影响以及治疗的需要,经常会采用到各种引流管,同时在术后切口一般也会进行引流管的防治,从而将各种脓、血性分泌物从体内导出,能够使患者术后感染的几率得到一定程度的降低,对患者伤口的愈合也有着促进作用[1]。因此,在护理工作中,护理人员要对患者术后引流液的颜色、性状以及量的大小进行密切观测,并做好记录,为医生对患者病情判断提供有效依据,并对患者下一步的治疗计划作出指导。

      1 引流管护理方法

      1.1 胃管护理 成人胃管的插入深度通常在45cm至55cm之间,当插管工作顺利完成后,对胃管采用透气胶布进行固定,通常在患者鼻尖位置固定。在护理过程中,护理人员每天应当定时更换胶布,并在更换过程中,對患者鼻腔采用棉签擦拭,要注意在棉签上沾上生理盐水。嘱咐患者尽量不要活动,防止胃管受压,防止胃管扭曲变形或掉落情况的发生,保持胃管通畅。 护理人员每日还要做到定时冲洗胃管,并对胃管位置进行判断,如果对胃管位置产生怀疑,认为胃管不在患者胃部内时,要及时向医生进行通知,并停止进行鼻饲。

      1.2 腹腔引流管的护理 腹腔引流管在放置后要对其放置的数量和位置进行标注,根据患者病情变化可以放置多根引流管,护理人员要对引流管的通畅性进行密切关注,对引流管状态进行实时观察,避免出现扭曲和受压情况,在腹带应用时更要小心,防止引流管受到影响。注意引流管的固定位置,防止患者在变换体位时发生脱出现象。此外,还要保持引流管和伤口接触位置的清洁,减少感染情况。在应用引流袋时,要确保引流袋位置不高于腹壁戳孔平面,避免引流物发生逆流导致腹腔发生感染。对引流管内的引流物性状、量以及颜色进行仔细观察,如果发现异常情况要及时通知医生采取处理措施。采用单管引流时,如果没有引流液流出,要仔细判断是否为假象,防止术后凝血块、脱落的组织碎屑堵塞引流管。要充分了解各种腹腔引流管的放置时间,通常在术后2-3d,引流停止24h将引流管拔除。如果是进行脓肿引流,要逐渐退出引流管,等到脓肿完全闭合后再将引流管拔除。

      1.3 T管引流护理 应认真观察并准确记录胆汁引流量,成人每日分泌胆汁800-1200ml,观察胆汁的颜色和性状,正常胆汁的颜色为黄色或黄绿色,清亮而无杂质。如胆汁引流量突然减少或无引流液,提示管道扭曲、堵塞或脱出,引流量过多提示胆道下梗阻,应及时通知医生予以处理。为帮助患者消化,可间断夹管,夹管期间,注意观察患者有无腹痛、黄疸、发热等不适,并做好基础护理及生活护理。

      2 在普外科护理中引流管护理需要注意的事项

      为了做好引流管的护理工作,首先要进行充分的评估,具体的评估内容主要包括以下几点:首先要对引流管位置和名称进行评估是否正确;其次要对引流管的固定方式进行评估是否具备合理性;对引流管的冲洗吸引通畅情况、设置准确性进行评估;对记录的全面性进行评估,评估是否存在色质描述,评估出入量的正确性;最后对引流管附近肤质情况进行评估。

      2.1 保证护理记录单的完整 通常情况下,由高资历的护理人员来对护理记录单中的内容进行审核,对医嘱再填写情况进行核对。确保填写内容具有真实性以及准确性,核对无问题后可以进行操作。要在固定的位置放置护理单,及时记录每一次护理相关操作,要注意对护理人员的名字以及护理操作时间做好标注。

      2.2 巡视 护理人员要对带有引流的病患进行多次巡视,确保每小时巡视一次。在巡视时要严格遵循“7看2问3签字”的原则。看:对引流管的通畅情况和外用冲洗液进行检查,对引流瓶的状况以及滴数相符情况进行观察,对引流管附近皮肤异常情况进行观察等。问:对患者的病情进行适当询问,根据实际情况采取针对性措施。签字:要求巡视人员对自己全名以及巡视时间做好备注。

      2.3 其他注意事项 如果患者存在血、气胸情况,要进行腹腔闭式引流装置的常规留置操作,对引流出的物质量和性状进行仔细观察和分析,并对引流管的严密程度进行关注,让其保持负压状态,确保引流的有效性;在患者手术结束后,通常使用引流袋,然而由于引流袋形状无法固定,无法对引流量进行准确记录,所以在完成手术后缺乏参考依据;引流袋中是通过引流袋下方排出液体的,排液过程不便捷,会有少量液体残留在引流袋内,这会较大的增加排液量和实际引流量之间的误差[3]。在临床中对引流液的性质和量进行正确把握,对护理工作的顺利执行有着促进作用,所以需要加强引流管的护理,对引流量进行仔细观察,从而客观判断患者术后的病情。

      3 结语

      综上所述,在普外科护理中,引流管有很多种类,做好引流管的护理工作,不仅能够提高护理质量,同时能够使患者的痛苦得到减小,保证手术脏器及切口愈合,预防感染和扩散,让患者尽快康复有十分重要的作用。护理人员要根据患者情况实施科学的引流管护理,正确判断引流液的量和性质,减少引流管护理不当导致的护理差错事件。从而达到有效的引流管护理的目的。

    论普外科护理中引流护理重要性

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