胆道手术T形管引流并发症的预防(附4例分析)

Complications from T-tube drainage of biliary tract surgery and their prevention(Report of 4 cases)

目的通过规范T形管放置和注意正确拔管各个细节,预防胆道手术T形管引流并发症。方法本组共收集胆道术后置T管36例,有4例在常规拔除T形管时,出现拔出困难和拔管后剧烈腹痛,分析拔管细节。结果胆道手术放置T形管时要注意管径选择、行径走向、剪管方法;在拔管的时候要严格遵守拔管指征,必须先行造影,了解胆总管下端通畅与否和是否有结石残留再决定能否拔管;同时要综合考虑是否有长期服用激素史、尽量了解既往腹部手术史的细节以及患者营养状况等因素。结论只要规范置管操作、注意拔管各个细节,就可有效避免并发症发生。

Objective To introduce the correct placement of T-tube and draw attention to details of extubation so as to pre- vent complications from T-tube drainage of biliary tract surgery. Methods When T-tube was placed in biliary surgery, such details should be paid attention to as choice of tube diameter, direction and tube shearing methods. Before extubation, angiogra- phy must first be conducted and indications of extubation be strictly observed. Meanwhile,history of taking hormones, details of abdominal surgery history and patients＂ nutrition state should also be taken into consideration. Results 36 cases of T-tube drainage of biliary tract surgery were included in this study. Extubation difficulty and severe abdominal pain after extubation oc- curred in 4 cases in the course of routine performance of T-tube extubation. So details of extubation must be called for. Conclu- sion Specified procedure of tube placement and attention paid to details of extubation can effectively prevent complications.