床边胆道造影指导胆囊切除术治疗胆石症手术配合体会.docVIP

床边胆道造影指导胆囊切除术治疗胆石症手术配合体会 　 作者：汪花香， 舒玉华， 陈燕珠 【关键词】 床边胆道造影；,,胆囊切除术；,,胆石症 　　摘要：目的：探讨床边胆道造影指导胆囊切除术治疗胆石症的手术护理经验。方法：回顾性分析64例采用床边胆道造影指导胆囊切除术治疗胆石症的手术过程的手术前护理、手术中配合的护理体会。结果：手术过程顺利开展，全部一次性清除左右胆管、胆总管残留的结石，手术中和手术后无严重并发症发生，患者恢复迅速。结论：详细的手术前护理、充分的器械及物品准备，仪器及器械的娴熟应用和熟练的手术配合是手术顺利, 快速开展，一次性清除左右胆管, 胆总管残留的结石, 减少胆石症患者胆囊切除术后胆道残留结石发生率, 取得治疗成功的必要条件。 　　关键词： 床边胆道造影； 胆囊切除术； 胆石症 　　Study on Cooperation at Operation with Cholecystectomy to Treat Cholelithias is Depending on the Result of Intraoperative Cholangiogram 　　　　Abstract：Objective: To gain insight into how nurses work well cooperation at operation with cholecystectomy to treat cholelithiasis depending on the result of intraoperative cholangiogram. Method: 64 cases of cholelithiasis patients with cholecystectomy to therapy the biliary calculi depending on the result of intraoperative cholangiogram were studied by retrospective analysis. Result: All the cases were operated smoothly and quickly on cholecystectomy to remove all biliary calculi in left and right biliary ducts and bile commoen duct without the severe complication, and all the patients recover quickly. Conclusion: In order to work well cooperation at operation with cholecystectomy to treat cholelithiasis quickly, in order to remove all biliary calculi in biliary ducts, and to decrease the rate of operation complication, the nurse must make good ready before the operation, including the equipment and drug, the nurse must cooperate perfectly during the operation. 　　Key words: Cholecystectomy; Intraoperative cholangiogram; Cholelithiasis 　　 　　术中胆道造影对降低胆道术后胆道残余结石和胆道损伤的发生率有重要价值。因此该方法已经进入临床应用，已经发展非常迅速。尤其床边小型C臂X光机及其即时成像系统的出现和应用,方便了手术和造影的快速开展。我院自2004年1月2006年10月共为64例病人施行了床边胆道造影指导胆囊切除术治疗胆石症，手术取得良好效果，现将手术前、手术中配合的护理体会介绍如下。 　　1 资料与方法 　　1.1 临床资料:本组64例, 男28例, 女36例; 平均为46±15岁。病史5～20年; 有黄疸史4例, 急慢性胰腺炎史8 例。手术前B超检查: 提示单纯性胆囊炎胆囊结石, 其中发现胆总管扩张,直径gt;10mm19例。均有行胆囊切除治疗胆石症的手术适应证，所有患者都知情同意进行手术治疗。 　　1.2 手术和造影方法:采用日产床边小型C臂X光机及其即时成像系统。在切除胆囊后,保留胆囊管约1.5 cm , 然后以胆道造影导管插入残存胆囊管, 以7号丝线结扎固定导管, 经此管注入25 %～30 %泛影葡胺30～