Literature Review Of Prevention And Treatment Of Stoma Complications (Clinical Analysis Of 152 Cases)

Background:Intestinal stoma is a surgical method to direct the intestinal tract out of the abdominal wall to achieve temporary or permanent fecal flow to excrete feces to replace the anal defecation function.Common methods of stoma are colostomy and ileostomy.Intestinal stoma to change the way of fecal discharge,to the patients caused by varying degrees of social,psychological pressure,quality of life greatly affected by the great impact.This effect is largely due to the higher incidence of ostomy complications,common complications such as stoma hernia,stoma stenosis and so not only high incidence and re-risk of surgery.In this study,we discuss the possible factors and prevention and treatment of stoma complications,and provide the clinical basis.AimThe aim of our study was to determine the prevention and treatment of stoma complications.Methods:The clinical data of 152 patients who underwent enterostomy from January 2013 to December 2014 in the Department of Gastrointestinal Surgery,Jiangsu Provincial People's Hospital,Jiangsu Province,China.There were 121 cases of colostomy,72 males and 49 females,31 cases of small intestine,20 cases of male and 11 cases of female.The causes of complications of enterostomy were analyzed by analyzing the age,operation,stoma and postoperative diagnosis of 152 patients.Through the follow-up of 152 patients,the occurrence of stoma complications,treatment and prognosis were analyzed to explore the prevention and treatment of stoma complications.Result:152 patients were included in the age of 21-90 years of age,the median age of 47 years.Among the 121 patients with colostomy,there are 113 cases of end colostomy(74.34%)and 8 cases of loop colostomy(5.26%).While,among the 31 patients with ileostomy,there are 7 cases of end ileostomy(4.60%)and 24 cases of loop ileostomy(15.78%).There were 62 cases(40.89%)of colorectal cancer,30 cases(19.73%)of colon cancer,24 cases(15.78%)of small intestinal obstruction,13 cases(8.55%)of necrotic sigmoid ring,9 cases of abdominal trauma 5.92%),rectal prolapse in 8 cases(5.26%)and large intestine obstruction in 6 cases(3.94%)in all patients with enterostomy.A total of 38 patients(25.0%)had a different degree of stoma complications within 2 years after surgery:enterostomy dermatitis in 14 cases(9.21%),infection around the stoma in 6 cases(3.94%),parastomal hernia in 6 cases(3.94%),skin and mucous membrane separation in 4 cases(2.63%),fistula of stoma in 3 cases(1.97%),hemorrhage in 2 cases(1.31%),ischemia in 1 case(0.65%),stenosis in 1 case(0.65%).The vast majority of patients have been timely and correct diagnosis and treatment,and achieved good results,cured or improved,but some serious complications also brought great pain to patients,such as:1 case of oral infection around the implementation of patients had underwent the debridement surgery;2 cases of patients with nasal hernia enema had implemented the second enterostomy,1 case of fistula patients with secondary enema surgery,1 case of ostomy bleeding patients with stoma bleeding operation.ConclusionIntestinal ostomy after the occurrence of complications associated with stoma,many types,the reasons for the complex,seriously affecting the quality of life of patients after surgery.But most of the stoma complications can be prevented,adequate preoperative preparation,reasonable surgical approach,correct stoma position,postoperative active treatment,timely observation and treatment,suitable ostomy apparatus and correct stoma Nursing is the key to prevention and treatment of intestinal stoma complications.