13例胆漏致胆汁性腹膜炎的护理研究

目的探讨T管拔除后胆漏致胆汁性腹膜炎的原因分析及处理措施。方法回顾性分析1992年12月至2012年11月胆总管手术术后拔T管发生胆漏13例的临床资料。结果全部患者经开腹和腹腔镜手术再引流,4～6周后逐日退管至拔管后痊愈。结论 T管拔除后胆漏的原因与多种因素有关,如营养不良、创面粘连不佳、窦道未形成等。拔管后严密观察,如有腹痛症状首先考虑胆漏可能,经开腹或腹腔镜探查再引流延迟拔管方可治愈。

Objective To discuss the reason and preventive measures of bile leakage and peritonitis af- ter removal of T-tube. Methods The clinical data of 13 cases with bile leakage and bile peritonitis after remov- al of T-tube after common bile duet operation in our hospital from December 1992 to November 2012 were retro- spectively analyzed. Resltlts All cases were open operation and laparoscopie operation, gradually pulled tube to extubation after drainage 4-6 weeks, they were all cured. Conclusion Bile leakage after removal of T-tube are related to many factors, such as malnutrition, poor wound adhesion, without formation of sinus tract. Extu- bation after close observation, such as abdominal pain first consider the bile leaks, by laparotomy or laparoseopy and drainage for delayed extubation can be cured.