不同插管方法对ERCP插管困难患者的干预和护理

Intervention and Nursing of Different Intubation Methods for Patients with Difficult Intubation in ERCP

目的:研究经内镜逆行胰胆管造影(ERCP)手术插管困难患者通过不同插管方法插管的有效护理配合。方法:选取2020年5月-2022年5月在江苏省宝应县人民医院进行ERCP手术插管困难的患者30例,采用回顾性分析的方法进行研究,其中通过针状刀乳头预切开插管的患者8例,实施针状刀乳头预切开插管护理,记为Ⅰ组;经胰管乳头预切开插管患者7例,实施胰管乳头预切开插管护理,记为Ⅱ组;通过双导丝插管患者10例,实施双导丝插管护理,记为Ⅲ组;通过胰管临时支架插管患者5例,实施胰管临时支架插管护理,记为Ⅳ组。评估不同组疗效差异。结果:4组患者的插管成功率比较,差异无统计学意义(P>0.05);对患者的胰腺炎发生率进行比较,Ⅲ组<Ⅳ组<Ⅰ组<Ⅱ组,差异有统计学意义(P<0.05)。结论:对ERCP手术插管困难的患者通过不同的插管方式均可以提升插管的成功率,但是患者所出现的术后胰腺炎发生概率不同,与插管方式存在关联,同时也与护理人员的护理经验和配合的娴熟度存在关联,应引起重视。

Objective:To study the effective nursing cooperation of patients with difficult intubation in endoscopic retrograde cholangiopancreatography(ERCP)with different intubation methods.Methods:From May 2020 to May 2022,30 patients with difficult intubation in ERCP surgery in Baoying County People's Hospital of Jiangsu Province were selected and retrospectively analyzed.Eight patients were treated with needle-shaped papillary pre-incision and intubation care,marked as group I;and 7 patients were treated with pancreatic duct papillary pre-incision and intubation care,marked as group II;10 patients were treated with double guide wire intubation care,marked as group III;and 5 patients treated with temporary pancreatic duct stent intubation care,marked as group IV.The difference of efficacy among groups was evaluated.Results:There was no significant difference in the success rate of intubation among the 4 groups(P>0.05);the incidence of pancreatitis was compared as group III<group IV<group I<group II,and the difference was statistically significant(P<0.05).Conclusion:Different intubation methods can improve the success rate of intubation in patients with difficult intubation in ERCP surgery,but the incidence of postoperative pancreatitis in patients is different,which is related to the intubation method,and is also related to the nursing staff’s nursing experience and the proficiency of cooperation,which should be concerned.