新型冠状病毒肺炎疫情期间急诊经皮肝穿刺胆管引流术的护理策略

Nursing strategy for emergency percutaneous transhepatic cholangial drainage during novel coronavirus pneumonia

目的探讨新型冠状病毒肺炎二级防护下和常规无菌操作下急诊经皮肝穿刺胆管引流术的成功率、病人在室时间和术后2周医患感染新型冠状病毒肺炎发生率。方法回顾性分析2019年1月1日至2020年4月30日完成急诊经皮肝穿刺胆管引流术43例。其中在新型冠状病毒肺炎二级防护下完成了7例患者,男3例,女4例,年龄范围在42~79岁,平均年龄为76.3岁。常规无菌操作下完成了36例患者,男23例,女13例,年龄范围在40~92岁,平均年龄为73.7岁。比较两组患者手术成功率、病人在室时间和术后2周医患感染新型冠状病毒肺炎发生率。结果对照组36例患者中,35例顺利完成穿刺,观察组7例患者均穿刺成功;对照组平均在室时间64.2 min,观察组平均在室时间为60.0 min。术后2周7例患者及参与的医务人员均未感染新型冠状病毒肺炎。结论新型冠状病毒肺炎疫情期间,急诊经皮肝穿刺胆管引流是一种安全有效的治疗方式,科学防护下不增加医患感染发生率和患者手术风险,可使病人获得最大收益。

Objective To investigate the success rate of emergency percutaneous transhepatic cholangial drainage,operation time and the infection rate in 2 weeks after surgery between secondary protection of virus and usual surgery preparation.Methods 43 patients who underwent percutaneous transhepatic cholangial drainage from January 1,2019 to April 30,2020 in our hospital,including 7 patients(3 males,4 females)aged 42-79 years(average 76.3 years)who received surgery under secondary protection of virus and 36 patients(23 males,13 females)aged 40-92 years(average 73.3 years)who received surgery under usual surgery preparation.The success rate of emergency percutaneous transhepatic cholangial drainage,operation time and the infection rate in 2 weeks after surgery between the two groups were compared.Results 35 patients were successfully completed the operation in the control group and 7 patients in the observation group were all completed successfully.The average time in the control group was 64.2 minutes and 60.0 minutes in the observation group.7 patients and participating doctors were not infected with the corona virus in 2 weeks after surgery.Conclusions Percutaneous transhepatic cholangial drainage is a safe and effective treatment method,which does not increase the rate of infection and the risk of surgery for patients during novel coronavirus pneumonia.