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目的:观察和分析恶性梗阻性黄疸患者经皮肝穿刺胆汁外引流术(PTCD)/经皮肝穿刺胆道支架置入术(PTBS)后的护理,并探讨其处理的相关措施。方法:选取2013年5月至2015年4月该院收治的晚期恶性梗阻性黄疸病例89例,对所有患者进行观察分析这6个月内并发症情况,总结相关处理措施和经验。结果:89例晚期恶性梗阻性黄疸患者于PTCD/PTBS术后出现近期并发症,发生率为41.5%,其中出血15例、逆行胆管感染13例、引流管堵塞和脱位3例、支架再狭窄及移位胆汁外溢2例、急性胰腺炎2例、电解质紊乱2例,37例并发症患者中死亡2例(2.2%),35例(39.3%)经对症治疗后好转。结论:PTBD或PTBS对恶性梗阻性黄疸的治疗是一种安全、有效的方法,合理的围手术期处理对降低并发症发生率及死亡率极为重要。绝大多数病人可转危为安。
OBJECTIVE: To observe and analyze the nursing care of patients with malignant obstructive jaundice after percutaneous transhepatic biliary drainage (PTCD) / percutaneous transhepatic biliary stenting (PTBS) and to explore the related measures. Methods: From May 2013 to April 2015, 89 patients with advanced malignant obstructive jaundice admitted from May 2013 to April 2015 in our hospital were selected. All the patients were observed and analyzed for complications within 6 months, and the related treatment measures and experiences were summarized. Results: A total of 89 patients with advanced malignant obstructive jaundice had postoperative complications after PTCD / PTBS. The incidence rate was 41.5%. Among them, 15 cases had hemorrhage, 13 cases had retrograde bile duct infection, 3 cases had drainage tube obstruction and dislocation, 3 cases had stent restenosis, 2 cases of displaced bile spill, 2 cases of acute pancreatitis, 2 cases of electrolyte disturbance, 2 cases of death in 37 cases of complications (2.2%), 35 cases (39.3%) improved after symptomatic treatment. Conclusions: The treatment of malignant obstructive jaundice by PTBD or PTBS is a safe and effective method. The reasonable perioperative management is very important for reducing the incidence of complications and mortality. The vast majority of patients can turn crises into peace.