36例胆道125I粒子支架置入治疗恶性梗阻性黄疸的护理观察

Nursing care for the treatment of malignant obstructive jaundice by biliary iodine-125 particle stent

目的:探讨胆道125I粒子支架植入术的护理体会。方法:通过对36例恶性胆道梗阻患者进行胆道125I粒子支架植入的护理,观察术前准备和心理疏导、术中护理配合、术后加强经皮穿刺胆管引流(PTCD)引流管管理、辐射防护及并发症的观察和护理。结果:术后2例患者并发胆道感染、1例患者并发轻度胰腺炎、9例患者畏寒、发热,均在给予对症治疗1周后治愈,1例患者在出院后23天死亡。1个月后随访,35例支架无堵塞,血清总胆红素、直接胆红素均较术前明显下降。结论:该治疗方法是治疗恶性胆道梗阻的一种安全有效的方法,患者治疗顺利与周密的术前准备,术中熟练配合和严密的监测,术后严密观察、精心护理是密不可分的。

Objective:To investigate the nursing methods and effects of 125I stent implantation for malignant biliary obstruction.Methods:Thirty-six cases of malignant biliary obstruction were treated with 125I seed stent implantation.Preoperative preparation and psychological counseling,intraoperative nursing cooperation,postoperative percutaneous transhepatic catheter drainage(PTCD)drainage management,radiation protection and complications observation and nursing were observed.Results:Two cases of postoperative patients with biliary tract infection,1 cases of patients with mild acute pancreatitis,9 cases of patients with chills and fever,were given symptomatic treatment after 1 weeks of healing,1 cases of patients discharged from the hospital 23 days after death.After 1 month follow-up,35 cases had no obstruction of the stent.The serum total bilirubin and direct bilirubin were significantly lower than those before operation.Conclusion:the treatment is a safe and effective way to treat malignant biliary obstruction.It is closely related to careful preoperative preparation,skillful cooperation and close monitoring during operation,close observation and careful nursing after operation.