摘要
目的总结造口周围坏疽性脓皮病(PPG)的临床特点及护理体会.方法回顾性纳入2014年6月至2018月6月在中山大学附属第六医院诊治的7例PPG患者并进行随访,随访时间截止为2019年6月30日.总结PPG患者的临床表现、基础疾病、治疗及转归.结果7例PPG患者,男性4例,女性3例;中位发病年龄36.0(23.0,37.0)岁.7例患者的基础疾病分别是克罗恩病(4例)、白塞病(2例)和外伤后直肠肛管损伤(1例).6例PPG发生在回肠造口,1例在结肠造口.中位疼痛评分为2.0(1.5,2.5)分;发病时间与造口手术时间间隔为7 d^60个月,中位间隔时间为30.0(13.5,922.5)d.7例患者均接受局部护理,根据湿性愈合原理处理创面,隔离粪水,每日或隔日换药;4例克罗恩病和2例白塞病采用免疫抑制剂和(或)激素治疗.PPG愈合时间为22 d^13个月,中位愈合时间为60.0(22.0,330.0)d.结论PPG多与基础疾病共存,愈合时间长.局部护理和针对原发病的药物治疗对创面的愈合有积极作用.
Objective To summarize the clinical features and nursing experience of parastomal pyoderma gangrenosum(PPG).Methods Seven patients with PPG receiving treatment and nursing care in The Sixth Affiliated Hospital of Sun Yat-sen University from June 2014 to June 2018 were retrospectively enrolled and a follow-up was carried out which ended in June 30th,2019.Clinical features,basic diseases,treatment,outcome and nursing experience of PPG were summarized.Results Among 7 PPG patients,4 were male and 3 were female.The median age of onset was 36.0(23.0,37.0)years old.The underlying diseases of 7 patients were Crohn's disease(4 cases),Behcet's disease(2 cases)and rectoanal canal injury after trauma(1 case).PPG of 6 patients occurred in ileal stoma and of 1 patient in colon stoma.The median pain score was 2.0(1.5,2.5)points.The interval between onset and ostomy ranged from 7 d to 60 months,with the median 30.0(13.5,922.5)d.All the 7 patients received local nursing.The moist healing principle was applied to the wounds.The convex ostomy bag and the belt were used to collect the manure water to prevent leakage.Drug was changed per 1 or 2 days.Four patients of Crohn's disease and 2 patients of Behcet's disease were treated with immunosuppressive agents and/or hormones.After nursing and treatment,the healing time ranged from 22 d to 13 months,with the median 60.0(22.0,330.0)d.Conclusions PPG coexists with underlying diseases usually and its healing time is quite long.Local nursing and medication therapy aiming primary disease has active effect on wound healing.
作者
叶新梅
何丹丹
梁伟文
何兰珍
张至英
陈瑰婷
赵洁
刘让
黄榕康
Ye Xinmei;He Dandan;Liang Weiwen;He Lanzhen;Zhang Zhiying;Chen Guiting;Zhao Jie;Liu Rang;Huang Rongkang(Department of Colorectal Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China)
出处
《中华炎性肠病杂志（中英文）》
2019年第4期341-344,共4页
Chinese Journal of Inflammatory Bowel Diseases
基金
2017年广州市科技计划项目(201704020059).
关键词
克罗恩病
造口周围坏疽性脓皮病
护理经验
Crohn's disease
Parastomal pyoderma gangrenosum
Nursing experience
作者简介
通信作者:黄榕康,Email:huangrk3@mail.sysu.edu.cn,电话:020-38254052
