无针密闭式输液接头在鼻胆管引流中的应用

The application of closed needle- free style injection connector in endoscopic nasobiliary drainage

目的：观察无针密闭式输液接头在内镜逆行胰胆管造影（ERCP）后放置鼻胆管引流中的护理应用效果。方法将胆总管结石行ERCP并放置鼻胆管的400例患者按时间先后分成2组，2013年6月1日至12月20日的200例患者设为对照组，2013年12月21日至2014年6月30日的200例患者为试验组，对照组采用鼻胆管直接与引流袋对接，试验组是将鼻胆管先与无针密闭式输液接头对接，衔接后再与引流袋对接。观察并比较2组胆汁外漏、鼻胆管接头处裂管、接头处分离、术后感染的发生率。结果对照组在胆汁外漏、鼻胆管接头处裂管、接头处分离、术后感染的发生率分别为35%（70/200）、11%（22/200）、6%（12/200）、6%（12/200），试验组分别为0、0、0、2%（4/200），差异有统计学意义（χ2=31.75～169.60，均P<0.01）。结论使用无针密闭式输液接头与鼻胆管直接对接，能有效降低鼻胆管衔接处分离、裂管、胆汁外漏以及术后感染的发生率，减轻了护理工作量，增加了护理满意度。

Objective To observe the nursing effect of closed needle-free style injection connector in endoscopic nasobiliary drainage (ERCP). Methods From June 2013 to June 2014, 400 patients of the common bile duct stones underwent ERCP technique and placed nasobiliary were divided into two groups according to chronological. Between June 1st, 2013 and December 20th, 200 patients were set as control group, between December 21th, 2013 and June 30, 2014, 200 patients were set as experimental group. For the control group, the nasobiliary duct was directedly connected to the disposable drainage bag. For the experimental group, the nasobiliary duct was connected to closed needle-free style injection connector, and then to the drainage bag. The incidences of the detached connection, the fracture of the connection with the nasobiliary duct, bile leakage from the connection, and post-ERCP infection were compared between two groups. Results The incidence of bile leakage, crack pipes, separation and postoperative infection occurred at the junction nasobiliary rates in the experimental group were 0,0,0,2%(4/200), which were far lower than 35% (70/200),11% (22/200), 6% (12/200), 6%(12/200) of the control group. The difference was statistically significant (χ2=31.75~169.60, P < 0.01). Conclusions The application of closed needle-free style injection connector can effectively avoid the detachment and fracture of the connection, the occurrence of bile leakage, and post-ERCP infection. This will be helpful to decrease the burden of nursing care and increase patients′satisficationdegree.