恶性梗阻性黄疸经皮穿刺引流联合胆道支架置入护理分析.docVIP

恶性梗阻性黄疸经皮穿刺引流联合胆道支架置入护理分析 　　[摘要] 目的 探讨护理干预对恶性梗阻性黄疸经皮穿刺引流联合胆道支架置入术的效果。 方法 选取我科接受经皮穿刺引流联合胆道支架置入术治疗的恶性胆道梗阻性黄疸患者37例为研究对象， 采用针对性护理干预方法，包括心理疏导、并发症预防、疼痛管理等，观察患者焦虑、抑郁等负性心理变化，术后1～3d疼痛评分变化以及手术相关并发症发生率，分析护理干预的效果。 结果 经护理干预后，患者手术前SAS、SDS评分较入院时显著降低（P 0.05）。患者术后有引流管迂曲、低热、疼痛等，均给予相关处理后好转，术后每日平均引流量 （657±242）mL，未发现引流不畅等现象。术后1 d、2 d、3 d患者VAS评分分别为（7.6±1.5）、（3.2±0.7）、（3.3±0.6）分，经比较发现，术后2 d、3 d VAS评分显著低于术后1 d（P 0.05）。 结论 护理干预可降低恶性梗阻性黄疸患者的术前负性心理情绪，降低术后并发症和疼痛感受，提高治疗效果，促进康复过程。 　　[关键词] 恶性梗阻性黄疸；胆道；支架置入术 　　[中图分类号] R473.6 [文献标识码] B [文章编号] 1673-9701（2013）25-0092-03 　　Nursing analysis of malignant obstructive jaundice by percutaneous puncture drainage combined with biliary stent placement 　　HU Mei WU Chaohui LIU Lizhi TONG Hongfei 　　Department of General Surgery， Ward of H09， Second Affiliated Hospital of Wenzhou Medical College， Wenzhou 325027， China 　　[Abstract] Objective To discuss the nursing intervention effect of malignant obstructive jaundice by percutaneous puncture drainage combined with biliary stent placement. Methods A total of 37 cases with malignant obstructive jaundice by percutaneous puncture drainage combined with biliary stent placement in our department were applied the nursing intervention methods including psychological counseling， prevention of complications and pain management.The negative psychological changes of anxiety and depression， pain scores changes at 1-3 days after operation and incidence of relational surgery complications of patients were observed， and the nursing intervention effect were analyzed. Results After nursing intervention， the SAS， SDS scores of patients before the surgery were significantly lower than those on admission（P 0.05）. The patients occurred tortuous drainage tube， low fever and pain after the surgery and improved by relative treatment. The postoperative mean daily drainage amount was （657±242） mL， and no poor drainage happened. The VAS scores of patients at 1 day， 2 days， 3 days after operation was 7.6±1.5，3.2±0.7，3.3±0.6 respecti