摘要
目的总结并探讨B超引导下经皮穿刺置管引流治疗经导管肝动脉化疗栓塞术（TACE）后并发肝脓肿患者的临床护理措施及要点。方法回顾性分析2008年3月至2012年11月间6例行TACE介入术后并发肝脓肿患者的资料。6例患者的治疗均予经皮穿刺置管引流方法，围手术期间给予术前准备与心理护理、术后生命体征监测与对症护理、置管后围导管护理、营养支持与并发症预防等护理干预措施，观察实施效果。结果5例患者置管10～15d后引流量逐渐减少，经B超或CT检查，脓腔显著缩小或接近闭合，稳定2d后成功拔管。l例多发性肝脓肿患者脓肿破裂并发感染性休克，于置管后32d死于肝功衰竭。结论在准确判定肝脓肿形成并行置管引流基础上，做好生命体征监测与病情观察、围导管护理及对症护理措施，是减少并发症，促进脓肿愈合的必要和有效措施。
Objective To summarize and discuss nursing care essentials on patients with liver abscess secondary to TACE undergoing percutaneous transhepatic cholangial drainage. Methods Retrospective study was conducted on 6 cases with liver abscess secondary toTACE from Mar. 2008 to Nov. 2012. 6 cases were all treated by ultrasound B guided percutaneous transhepatic cholangial drainage method. Preoperative preparation, psychological nursing, postoperative monitoring of vital signs and symptomatic care, peri-catheter nursing after puncture, nutritional support and the prevention of complications et al were implemented,which therapeutic effects were observed. Results Drainage volume of 5 patients reduced gradually after implanting 10-15d tube, and the abscess cavities were significantly reduced or closed under CT scanner. They were successfully extubated in the next 2 days. 1 case with multiple liver abscess occured abscess rupture and complicated with septic shock, who died of liver failure after drainage for 32d. Conclusions Based on accurate determination of liver abscess formation and percutaneous transhepatic cholangial drainage, monitoring vital signs and observation of patients condition, peri-catheter nursing after pereutaneous puncture catheter drainage are necessary and effective measures to reduce complication and to promote healing of liver abscess.
出处
《中国肿瘤临床与康复》
2013年第11期1300-1303,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
经导管肝动脉化疗栓塞术
肝脓肿
穿刺置管引流
护理
Transcatheter arterial chemotherapy and embolization （TACE）
Liver abscess
Percutaneous transhepatic cholangial drainage
Nursing
