经皮肝微造瘘治疗肝内胆管结石的护理研究

Nursing research of percutaneous liver micro ostomy in treatment of hepatolithiasis

目的探讨经皮肝微造瘘治疗肝内胆管结石的护理效果。方法回顾性分析笔者所在科自2010年6月～2011年7月采用经皮肝微造瘘治疗肝内胆管结石的治疗和护理方法。重点观察腹腔情况、有无胆瘘及护理并发症。结果 22例均成功施行经皮肝微造瘘术,其中15例取净结石,7例仍有少许残余结石,结石取净率为68.2%。6例患者出血量>50ml,术后并发右侧胸腔积液和右下肺不张1例,经保守治疗后痊愈。无胆瘘、胆汁性腹膜炎、护理并发症及死亡情况。结论积极细致的病情观察和优质护理,能提高经皮肝微造瘘治疗肝内胆管结石的手术效果,减少、预防并发症的发生,有利于患者的康复。

Objective To evaluate the nursing effects of percutaneous liver micro ostomy in treatment of hepatolithiasis. Methods From June 2010 to July 2011, the treatment and nursing methods of percutaneous liver micro ostomy in treatment of hepatolithiasis were retro spectively analysed in the authors＇ department. The observation focused on the condition of enterocoelia, biliaryfistula and nursing complica tion. Results All operations were successful, including 15 cases （ 68.2% ） that took out stones completely and 7 cases of few residual stones. The bleeding volume of 6 patients was more than 50 ml, 1 case with postoperation right pleural effusion and lower right atelectasis re covered after conservative treatment. No biliaryilstula, biliary peritonitis, nursing complications and death occurred. Conclusion Careful ob servation and high quality nursing can improve the surgical effects of percutaneous liver micro ostomy in treatment of hepatolithiasis ,reduce and prevent complications, it is conducive to rehabilitation.