10例严重胰腺损伤行胰胃吻合并胰管外引流术的护理

Nursing care of 10 patients with severe pancreatic injuries undergoing pancreaticogastrostomy combined with external drainage of pancreatic duct

总结了10例严重胰腺损伤患者行胰胃吻合并胰管外引流术的护理。充分了解手术方式及特点,明确胃管、空肠造瘘管、胰胃吻合口旁腹腔引流管、胰管引流管留置的临床意义,加强各引流管管理;制订针对性的胰液回输及肠内营养护理方案,根据患者实际营养状况评估结果,适时调整肠内营养方案。本组1例患者因合并肝脏严重挫裂伤、十二指肠破裂及门静脉挫伤于术后10h死亡;其他9例术后未出现胰瘘、吻合口瘘等并发症,未出现明显胰腺内外分泌功能障碍。

This paper introduces the experience of nursing care of 10 patients with severe pancreatic injuries undergoing panereaticogastrostomy combined with external drainage of pancreatic duct. The key points in nursing were strengthening drainage management based on fully understanding of the characteristics of pancreatieogastrostomy and the significance of gastric tube,jejunostomy tube and drainage of pancreatic duct,formulating and adjusting the protocol of reinfusion of pancreatic juice and enteral nutrition based on dynamic nutritional assessment. As a resuh,a patient died of severe liver injury,duodenal rapture and portal vein injury at 10 hours after operation,and the other nine patients recovered without pancreatic fistula or anastomotic fistula,or pancreatic secretion disorders.