内镜下食管静脉曲张套扎术治疗食管胃底静脉曲张破裂的护理干预

Nursing intervention of endoscopic esophageal variceal ligation in the treatment of esophageal variceal bleeding

目的探讨护理干预在食管静脉曲张破裂出血内镜下食管静脉曲张套扎术(endoscope variceal figadon,EVL)治疗中的作用。方法回顾性分析本院2008年6月～2011年6月收治的116例食管静脉曲张患者内镜下行食管静脉曲张套扎术(EVL)的治疗和护理资料。结果本组116例患者中,110例第1次套扎达到止血效果,止血率为94.8%;有4例第1次套扎术后再次出血,经再次套扎后,未再出血,发生率为3.4%;有2例第1次套扎术后再次出血,经再次套扎后,配合H2受体阻滞剂治疗未再出血,发生率为1.7%。套扎术治疗后2周,所有患者均按时复查,其中4例食管曲张静脉消失,109例患者食管曲张静脉均有不同程度的减轻,3例食管曲张静脉再出血者行了二次套扎治疗。结论全面细致地做好术前准备、术中配合、术后护理有助于提高手术效果、减少并发症。

Objective To investigate the effect of nursing intervention of endoscopic esophageal variceal ligation （EVL） in the treatment of esophageal variceal bleeding. Methods Treatment and care data of 116 cases of patients who were treated with EVL were analyzed retrospectively in our hospital from June 2008 to June 2011. Results Among 116 cases, 110 cases reached the effect of first ligation hemostasis, and the hemostasis rate was 94.8%. 4 cases had re-bleeding after the first ligation and were treated with re-ligation, who had no further bleeding, the occurrence was 3.4%. 2 cases had re-bleeding after the first ligation and were treated with re-ligation combined with H2 receptor blockers, who had no further bleeding, the occurrence rate was 1.7%. 2 weeks after EVL treatment, all patients were reviewed on time, esophageal varices was dis- appeared in 4 cases, which was lightened of varying degrees in 109 cases, and 3 cases of esophageal variceal re-bleeding patients were treated with a second ligation. Conclusion The comprehensive and meticulous preoperative preparation, intraoperative cooperation and postoperative care can help to improve the surgical effects and reduce complication.