经颈静脉肝内门腔静脉分流术后患者并发症的观察及护理

Complications and Nursing Points in Patients after Transjugular Intrahepatic Portosystemic Shunt

目的探讨经颈静脉肝内门腔静脉分流术(transjugular intrahepatic portosystemic shunt,TIPS)后患者并发症的发生情况及其护理方法。方法回顾性分析2008-2010年在南京大学医学院附属鼓楼医院消化科行TIPS治疗的40例患者出院后6个月内并发症的发生情况,总结其发生原因以及预防和处理这些并发症的经验。结果 TIPS治疗后6个月内的并发症包括腹腔积液、下肢水肿、消化道再出血和肝性脑病等。结论 TIPS术后适当地限制盐和水的摄入、维持正常排便、预防感染、控制蛋白摄入和定期随诊,有助于提高TIPS的长期疗效。

Objective To explore the complications and causes as well as key nursing points in patients after transjugular intrahepatic portosystemic shunt （TIPS）. Methods The complications and relevant causes 6 months after TIPS therapy were retrospectively analyzed in 40 patients,and the experience of complicaton prophylaxis and nursing were summarized. Results Ascites,edema of lower extremity,gastrointestinal bleeding and hepatic encephalopathy were the major complications 6 months after TIPS treatment. The main nursing points included proper limitation of salt and water intake, keeping regular and normal defecation, prevention of infection disease, rational protein intake control and regular follow-up in clinic. Conclusion Active follow-up nursing care for patients discharged from hospital after TIPS therapy could probably decrease incidence of complications and benefit long-term effect of TIPS.