放射性粒子联合胆道支架治疗肝门部胆管癌并发症的防治与针对性护理

目的探讨放射性粒子联合胆道支架治疗肝门部胆管癌术后并发症的防治与针对性护理方法。方法对96例肝门部胆管癌患者,所有患者均接受经皮肝胆管引流(Percutaneous transhepatic cholangial drainage,PTCD)及金属内支架植入术,术后7天在CT引导下行125I放射性粒子植入术,观察术后并发症情况及护理。结果共20例患者出现了不同程度并发症,其中菌血症3例、胆汁性腹膜炎4例、胆汁血症3例、胆汁瘤1例、放射性肠炎5例、皮下血肿2例、粒子迁移2例。结论放射性粒子联合胆道支架治疗肝门部胆管癌疗效显著,通过精心的护理可有效减少并发症的发生,提高手术疗效。

Objective To explore the methods and curative effect of targeted nursing on the complications of biliary stents combined with 125I radioactive particles in the treatment of hilar cholangiocarcinoma. Methods A total of 96 patients with hilar cholangiocarcinoma received PTCD and metallic biliary stents placement, 1 week later received ^125I radioactive particles implantation guided by CT. Targeted nursing was provided to the patients with complications. Results Totally 21 cases （20.0%） had developed different postoperative complications. Among them, bacteremia was in 3 cases, biliary peritonitis in 4 cases, bile of blood in 3 cases, biloma in 1 case, radiation enteritis in 5 cases, ecchymoma in 2 cases, particle immigration in 2 cases. Conclusion Metallic biliary stents placement combined with ^125I radioactive particles implantation can get better therapeutic efficacy. Careful nursing can prevent complications occurrence and enhance operative quality.