肝内胆管结石术后病人的观察及护理

Postoperative Observation and Nursing for Calculus of Intrahepatic Duct Patients

目的总结肝内胆管结石围手术期的护理要点、总结护理经验。方法回顾性分析我院自2005年1月-2010年12月手术治疗肝内外胆管结石150例的临床、护理资料,对其术前全身及营养情况做详细评估,术后密切观察生命体征及病情变化,保证有效循环血量,防治低血压;保持各引流管通畅,加强基础护理及术后并发症的观察及护理。结果该150例复杂肝内胆管结石患者均做了肝叶切除术,无1例手术死亡,其中,伤口感染20例,膈下感染10例,胆漏55例,肺部感染15例,均经非手术治愈。150例共81例获得随访,随访率53.0%,疗效优良率为77.8%,残石率为21.0%,结石复发率为8.7%。结论做好围手术期的护理,尤其是增强术后的护理观察,提高术后护理质量,巩固手术疗效和促进病人康复至关重要。

Objective To sumarize the perioperative nursing of the patients with calculus of intrahepatic duct and to review our experience.Methods Retrospectively analyze the clinical and nursing datum of 150 cases underwent operation to treat the calculus of intrahepatic duct from Jan2005 to Dec2010.Before opration,we evaluate the patient＇s general condition nutritional status in detail.After operation,we pay high attention to the sick＇s life index,ensure the adequate effctive circalation,prevent hypotension,smoother drainage,strengthen basic nursing and observation and nursing of postoperation complications.Results All the 150 cases had underwnet lobectomy of liver,no one is dead.These include： 7 cases of incisional infection,10 cases of inferior phrenic infection,55 cases of bile leakage,15 cases of pulmonary infection,all were cured by conservative therapy.Among 150 cases,81 patinets acquire follow-up,the follow-up rate reach 53.0% and good efficacy rate run to 77.8%.The patient with remnant stones approached 21.0%,recurrence rate of bile stone was about 8.7%.Conclusion Good perioperative nursing,especial intensive postoperation nursing observe,and higher postoperation nursing quality is crucially important for us to consolidate of operational efficacy and promote the sick＇s health.