T型管早期造影夹管的临床护理研究

Clinical Research on Early Griping T-tube and Nursing

目的探讨胆总管切开探查术后，T型管的合适夹管时间以减少胆汁丢失的方法。方法将91例胆总管切开取石术，T型管引流的病人随机分为两组：早夹管组在术后4～6天行T型管造影显示通畅后即行夹管；常规组按常规方法术后2周造影再夹管。两组进行比较。结果早夹管组胆汁丢失量、胆汁中丢失的电解质的含量、输液量及天数、平均住院天数、住院费用等方面与常规组比较有显著差异（P〈0．01）。结论胆总管切开取石术后早期造影，早央管能减少胆汁的丢失．并发症少，利于病人康复。

Objective To explore the proper time of griping T-tube and the method which can reduce the loss of the bile after choledochotomy with exploration. Methods 91 cases of patients with T-tube drainage following choledocholithotomy was randomly divided into two groups. The patients in the early pipe-griping group were undertaken T-tube cholangiography 4-6 days after the operation,and once the tube was showed to be unobstructed ,it would be clamped. The other group received routine method and the T-tubes were clamped according to result of cholangiography 2 weeks after the operation. Results In the early pipe-griping group, the loss of bile and the electrolyte in it, the amount and days of transfusion, the average hospitalization timing and the cost of hospitalization were showed to be significant deviation comparing with the routine group （p〈0.01）. Conclusion In the group which undertook early cholangiography and early pipe-tube griping, the function of bowels recovered faster, the amount of transfusion decreased, the hospitalized timing turned out to he shorters, and the nursing care were more convenient. On the whole, early cholangiography and early pipe-griping after choledochotomy can reduce the loss of bile and the occurrence of the complications, and make the patients recovered faster.