恶性梗阻性黄疸患者介入治疗术后护理体会.docVIP

恶性梗阻性黄疸患者介入治疗术后护理体会[摘要] 目的:总结恶性梗阻性黄疸患者介入治疗(PTCD+胆道内支架术)术后的护理经验,以减少并发症,提高护理质量。方法:对我院34例恶性梗阻性黄疸患者介入治疗术后的护理进行回顾性分析总结。结果:本组术后5例出现血性胆汁引流液,4例血淀粉酶升高,3例发生胆系感染,1例支架管脱落,经积极正确的治疗和精心的护理后临床治愈出院。结论:做好恶性梗阻性黄疸患者介入治疗术后的并发症观察与护理非常重要。 [关键词] 恶性梗阻性黄疸;介入治疗;护理 [中图分类号] R473.6[文献标识码]C [文章编号]1673-7210(2010)02(c)-096-02 Intervention nursing experience for patients with m alignant obstructive jaundice ZHANG Sufang1, WANG Zhixue2,WANG Hua1 (1.The First Affiliated Hospital of He’nan University, Kaifeng 475001,China;2.Medical College of He’nan University, Kaifeng 475001, China) [Abstract] Objective: Summarize the postoperative nursing experience of m alignant obstructive jaundice in patients with interventional therapy (PTCD + biliary stenting), in order to reduce complications and improve quality of care. Methods: 34 patients with m alignantobstructive jaundice after interventional treatment of care were retrospectively analyzed and summarized. Results: In this group bloody fluid biliary drainage occurred in five cases, serum amylase occurred in 4 cases and biliary tract infectionoccurred in 3 cases,stenting off occurred in 1 cases. After active treatment and careful nursing,the patients were cured. Conclusion: Observation and care is very important for complications after Interventional treatment of m alignant obstructive jaundice. [Key words] M alignant biliary obstruction;Intervention; Nursing 恶性梗阻性黄疸(m alignant biliary obstruction)是一组由胆管系统管腔内、外或管壁本身的恶性病变引起的机械性阻塞,而介入治疗的微创性、可重复性、易于操作、安全准确以及不受梗阻部位限制等优点,使其成为解除梗阻的首选疗法[1-2]。介入治疗术后也存在诸多的问题,如若处理不及时、不得当,可危及患者生命。现将我科2006年1月~2009年1月介入治疗的34例恶性梗阻性黄疸介入术后护理经验,分析如下: 1 资料与方法 1.1一般资料 从2006年1月~2009年1月共收治恶性梗阻性黄疸患者34例,其中,男25例,女9例,年龄40~85岁,术前经B超、CT、MRCT等检察确诊,其中肝部胆管癌16例,胆囊癌11例,胰头癌4例,壶腹癌3例,患者均表现为中、重度皮肤、巩膜黄染,食欲差,腹胀,尿黄大便呈陶土色等。手术采用局部麻醉,选择右侧腋中线第八九肋间为穿刺点21例,B超引导下剑突下为穿刺点13例,术中常规使用氟美松10 mg,立止血1 KU静脉给药。 1.2术后护理 1.2.1 一般护理包括生命体征观察,术后绝对卧床12 h、禁食水6 h并24 h内持续心电监护,观察患者皮肤及巩膜黄染有无消退,大便及尿液颜色是否恢复正常,详细记录24 h出入量。6 h后给予营养丰富易消化的低脂肪流质饮食,24 h后逐渐半流食。若