胆汁体外转流治疗晚期壶腹周围癌的疗效观察及护理干预

Observation on efficacy of treatment of advanced periampullary cancer with bile extracorporeal shunt and nursing intervention

目的探讨胆汁体外转流姑息性治疗晚期壶腹周围癌对改善患者症状和提高生存质量的可行性。方法 60例壶腹周围癌患者随机分为两组,研究组30例和对照组30例,研究组采用胆汁T管引流与空肠造瘘管在体外连接形成外桥式内引流术持续转流胆汁,对照组采用胆汁T管引流后每日2次集中经空肠造瘘回输胆汁,比较两组患者症状改善及并发症情况。结果研究组治疗后患者症状改善与对照组差异有显著性(P<0.05),研究组并发症发生率明显低于对照组(P<0.01)。结论胆汁T管引流直接与空肠造瘘管体外连接回输胆汁治疗晚期壶腹周围癌,可明显改善患者症状,减少胆汁回输的并发症。

Objective To investigate the feasibility of use bile extracorporeal shunt as palliative treatment of advanced periampullary carcinoma to improve the symptoms and the quality of life.Methods Sixty cases of periampullary carcinoma were randomly divided into two groups of 30 patients each： a study group and a control group.The study group used biliary T-tube drainage and the T-tube was connected with jejunostomy tube outside the body to form exterual bridge-type internal drainage as bypass for continuous drain of bile.The control group used T-tube for drain of bile which was collected 2 times a day and reinfused into jejunum through jejunostomy.Improvement of symptoms and complications were compared between the 2 groups.Results There was statistical difference between the study group and control group in symptom improvement after treatment（P0.05）,and the complication rate in the study group was significantly lower than that in the control group（P0.01）.Conclusion Extracorporeal connection of the T-tube for drainage of bile with the jejunostomy tube and bile reinfusion for treatment of advanced periampullary carcinoma can significantly improve symptoms and reduce complications of bile reinfusion.