胆道支架置入联合γ刀治疗复杂型肝门部胆管癌的护理

Nursing of Treatment with Biliary Stent Placement and Gamma-knife for Complex Hilar Cholangiocarcinoma

目的探讨胆道支架置入联合γ刀治疗复杂型肝门部胆管癌的护理方法。方法 2008年7月至2010年7月对15例无法手术切除的复杂型肝门部胆管癌患者行胆道置入金属支架引流联合γ刀治疗,回顾性总结相关临床资料及护理措施。结果γ刀治疗结束后2～3个月行CT检查,全部病例原发灶的完全缓解率为26.67%(4/15),部分缓解率为60.0%(9/15),病灶无变化为13.33%(2/15),未发现新病灶或原有病变进展。随访8～34个月,中位生存期为15个月,未发生再梗阻情况。结论胆道支架置入联合γ刀治疗复杂型肝门部胆管癌安全有效;治疗过程中,护理人员为患者提供及时有效的心理支持,密切观察患者病情、加强基础护理及针对性护理措施,是提高治疗效果的前提条件和有力保证。

gamma- Objective ife for comp with complex hilar cho To investigate the nursing methods of lex hilar cholangiocarcinoma. Methods langiocarcinoma classified with bismuth treatment with biliary stent placement and From July 2008 to July 2010,15 patients classification combined with stenosis of dis- tant common bile duct were treated with biliary stent placement and gamma-knife. The clinical data and nursing countermeasures were summarized retrospectively. Results All patients underwent CT examina- tion in 2-3 months after the gamma knife treatment. The complete remission rate of primary tumor was 26.67 % （4/15） ; the partial response rate was 60.0 G （9/15） ; the lesions did not change in 13.33 % （2/15） cases. No new lesion was detected or no existing lesion developed. The patients were followed up for 8-34 months. The median survival accounted for 15 months and no reobstruction occurred. Conclusion The combination of metallic stenting and gamma-knife is a safe and effective treatment for complex hilar cholangiocarcinoma. Timely and effective psychological support and psychological counseling, combined with close observation of patient＇s condition, strengthened basic care and targeted nursing interventions is a prerequisite and a strong guarantee to improve the therapeutic effect.