胰十二指肠切除术后并发症的护理现状

Nursing status of postoperative complications of pancreaticoduodenectomy

根治性胰十二指肠切除术是目前治疗胰腺癌、壶腹癌、胆总管下段癌及十二指肠癌的有效治疗方法,也是腹部外科中最复杂、切除器官及组织最多的手术之一。近年来随着医疗水平的提高,手术技术的成熟,手术数量也明显上升,但因为手术切除器官组织多、创伤大及时间长,导致术后并发症的发生率和围术期病死率增高。由于术后吻合复杂、留置管路较多,给临床护理工作也带来了较大困难。同时术后患者的恢复较慢,也对临床护理质量提出了更高的要求。本文观察分析了胰十二指肠切除术后发病率较高的并发症护理,包括胰瘘、胆瘘、术后出血、术后感染及胃排空障碍,并对并发症的相应护理措施的现状进行综述,更好地指导临床护理工作,使术后护理工作更具有针对性,为有效预防、及时控制术后并发症,提高患者术后生活质量,降低围术期病死率提供参考依据。

Radical pancreatoduodenectomy is an effective treatment of pancreatic cancer,ampullary cancer,carcinoma of lower segment of common bile duct and duodenal cancer,and it is also one of the most complex operations in abdominal surgery with the most of organs and tissues removed.In recent years,with the improvement of medical level and the maturity of surgical techniques,the number of operations has also increased significantly.However,the incidence of postoperative complications and perioperative mortality have increased due to the large number of surgical organs and tissues removed,large wound and long healing.The complex postoperative anastomosis and more indwelling pipelines also brings great difficulties to the clinical nursing work.At the same time,the recovery of postoperative patients is slow,which also puts forward higher requirements for the quality of clinical nursing.This article observes and analyzes the higher incidence rate of complications after pancreaticoduodenectomy,including pancreatic fistula,biliary fistula,postoperative bleeding,postoperative infection and gastric emptying disorders,and reviews the current status of the corresponding nursing measures for complications,so as to better guide the clinical nursing work,make the postoperative nursing work more targeted,and provide a reference basis for effectively preventing and timely controlling postoperative complications,improving the postoperative quality of life and reducing the perioperative mortality.