高龄胆总管结石患者内镜下胰胆管造影取石术的疗效及围手术期护理

Preoperative nursing of elderly patients with common bile duct stones undergoing endoscopic retrograde cholangiopancreatography

目的探讨内镜逆行胰胆管造影(ERCP)治疗高龄胆总管结石患者的疗效及围手术期护理方法。方法回顾性分析124例胆总管结石行ERCP取石的高龄患者的临床资料,根据年龄分组,其中83例年龄≥70岁为高龄组,41例年龄60~69的岁为非高龄组。对比2组患者治疗成功率、一次性取石成功率及并发症发生率。结果高龄组患者治疗成功率98.8%(82/83),非高龄组患者治疗成功率97.6%(40/41),2组比较差异无统计学意义(P>0.05)。高龄组一次性取石成功率91.6%(76/83),非高龄组为97.6%(40/41),2组比较差异无统计学意义(P>0.05)。高龄组术后并发症发生率30.1%(25/83),非高龄组术后并发症发生率46.3%(19/41),2组比较差异无统计学意义(P>0.05)。结论高龄胆总管结石患者行ERCP取石安全、有效。充分术前评估、准确的术中配合、术后严密的病情观察及并发症的护理是高龄患者手术成功、术后康复的必要条件。

Objective To investigate the perioperative nursing care of elderly patients with common bile duct stones treated by endoscopic retrograde cholangiopancreatography（ ERCP）.Methods A retrospective analysis with 124 patients aged equal to or more than 60 years old patients with common bile duct stones treated by ERCP was conducted. According to the age,83 cases aged equal to or more than 70 years old were assigned to senile group,and another 41 cases of age between 60 and 69 years old were assigned to the non-senile group. The success rate of treatment,one-time success rate and incidence of complication were compared between twogroups.Results The success rate of treatment was 98. 8%（ 82 /83） in senile group and was 97. 6%（ 40 / 41） in the non-senile group,with no significant difference（ P〉0. 05）. the one-time success rate was 91. 6%（ 76 /83） in the senile group and was96. 7%（ 40 /41） in the non-senile group,with no significant difference（ P〉0. 05）. The incidence of postoperative complication was 30.1%（ 25 /83） in the senile group and was 46. 3%（ 19 / 41） in the non-senile group,with no significant difference（ P〉0. 05）. Conclusion ERCP is safe and effective for elderly patients with common bile duct stones. Adequate preoperative evaluation,accurate intraoperative coordination,strict postoperative observation and nursing care on complications are necessary issues for the success of operation and postoperative rehabilitation.