胆囊穿剌置管引流治疗老年化脓性胆囊炎的护理

Nursing of acute suppurative cholecystitis by percutaneous transhepatic gallbladder drainage in the aged

目的：探讨经皮经肝胆囊穿刺置管引流（PTGBD）治疗老年急性化脓性胆囊炎的护理方法.方法：采用B超监视下定位PIED套管针经皮经肝穿刺胆囊,留置8.5F外引流管持续引流冲洗.结果：18例患者均一次穿剌置管成功,首次引流脓液50～120ml.引流后患者全身症状和体征迅速好转,7～10天后症状基本消失,白细胞计数恢复正常.置管维持7～15天,住院16～31天,平均18.9天,18例患者均痊愈,无出血、胆汁性腹膜炎等并发症.结论：经皮经肝胆囊穿刺置管引流术对不能耐受手术的老年急性化脓性胆囊炎患者是一种安全、微创和有效的方法,全面严密细致的术前准备及术后护理,有助于提高手术的疗效和减少并发症.

Objective： To investigate nursing methods in acute suppurative cholecystitis by percutancons transhepatic gallbladder drainage（PTGBD） in the aged.Methods： PIED were performed on percutaneons transhepatic and transgallbladder route drainage under guidance by ultrasound, 8.5F external drainage tube were imbedded for constant drainage and clysis after puncture were successful. Resuits：Puncture and catheterization were successful in 18 cases, drained hquor puffs was 50 - 120ml at first time. Clinical symptoms and signs disappeared rapidly after drainage and white blood cell count became normal after 7 to 10 days. Drainage last 7 - 15 days. It were 16 - 31 days during inpatient. 18.9 days on average. 18 cases were all recovery. There was no haemorrhage, bile peritonitis or other comphcations in all. Conclusion： PTGBD is a secure, less invasive and more effective method for the aged with acute suppurative cholecystitis without operation. Sufficient preparation rigorous and micromesh nursing and mental nursing can assistant improve therapeutic effect and decrease complications at preor post-operative perieds.