内镜下鼻胆管引流患者应用三通管冲管的效果观察

Effect of Modified Pipe-washing on Patients with Endoscopic Nasobiliary Drainage

目的探讨三通管冲管法在内镜下鼻胆管引流患者中的应用效果。方法选取100例行内镜下鼻胆管引流的患者,按置管时间分为观察组和对照组各50例。观察组鼻胆管末端连接三通管,而将三通管另外2个接口分别与一次性引流袋、输液器连接。通过三通管,夹闭引流袋,使抗菌药物溶液通过输液器冲入管内,然后关闭输液器,再次调节三通管,打开引流袋,充分引流胆汁;对照组鼻胆管末端连接注射器,用冲管液抽吸式冲管,观察两组患者的冲管时间、腋温、白细胞计数、血清淀粉酶及冲管时的腹痛程度。结果冲管时间、腹痛程度比较上,观察组明显优于对照组(P<0.05);腋温、白细胞计数、血清淀粉酶的比较,两组差异无统计学意义(P>0.05)。结论三通管冲管法在冲管时间、腹痛程度上优于传统冲管法,在疗效上可达到传统式冲管法所产生的预期效果。

Objective To observe the effect of modified pipe-washing method on patients with endoscopic nasobiliary drainage （ENBD）. Methods One hundred patients with routine endoscopic nasal biliary drainage were divided into observation group （n=50） and control group （n=50）. In observation group, nasobiliary end was connected with tee tube, the other two interfaces of which were connected with disposable drainage bag and infusion sets. After drainage bag was clipped through tee tube, antibiotic solution entered into the tube through infusion sets. Then infusion set was closed and tee tube was adjusted to open the drainage bag for adequate drainage of bile. In control group nasobiliary end was connected with ligation syringes, and was washed with pipe-washing solution. Pipe-washing time, axillary temperature, white blood cell count, serum amylase and abdominal pain during pipe-washing were observed. Results There were shorter pipe-washing time and less abdominal pain in observation group （P〈0.05）; comparison of axillary temperature, leukocyte count and serum amylase demonstrated no significant difference （P〉0.05）. Conclusion The modified pipe-washing method requires shorter time and causes less abdominal pain while it is as effective as traditional method in terms of efficacy, which is worth to be popularized.