肝移植术后胆道狭窄患者PTCD围手术期的外科护理研究进展

Perioperative Care of Percutaneous Transhepatic Cholangial Drainage (PTCD) for Post-Transplantation Biliary Stricture Patients: A Review

肝移植后由各种原因引起的胆道狭窄是一类常见的手术并发症,发生率约9.3%~27%,占肝脏移植术后死亡原因的15%~34%,严重影响肝移植患者的预后和生存。经皮肝穿刺胆道引流(Percutaneous Transhepatic Cholangial Drainage, PTCD)作为迅速减轻患者黄疸、改善全身状况、争取治疗时间的有效治疗措施,已经广泛应用于移植术后胆道狭窄的患者。然而,PTCD也存在术后出血、感染、堵塞、脱管等一系列问题,而且移植患者具有手术创伤大、病情复杂、免疫力低下等一系列的特殊性,所以PTCD术前术后妥善的护理措施对于加强PTCD治疗效果、减少PTCD相关并发症有至关重要的作用。

Biliary stricture is a common complication after liver transplantation with an incidence rate between 9.3% and 27%, causing death in about 15%-34% of postoperative stricture patients. Percutaneous transhepatic cholangial drainage (PTCD) as a rapid and effective method for relieving jaundice has wildly applied in patients with biliary stricture after liver transplantation. However, bleeding, infection, drainage tube obstruction, leakage, drop off and other complications after PTCD has plagued clinical doctors, nurses, and patients. In addition, the survival of liver transplant patients is complicated by suppressed immunity. So intensive PTCD perioperative care for post-transplantation biliary stricture patients is important to reduce complications after PTCD, and thus improve patient prognosis.