摘要
目的:探讨恶性梗阻性黄疸患者经皮穿肝胆管引流术(PTCD)联合支架植入术治疗后患者的生存状况及需加强的护理干预。方法:对近期收治的154例恶性梗阻性黄疸行PTCD联合支架术患者的临床病案资料进行回顾性分析,观察患者胆红素下降情况及黄疸改善情况;随访患者出院后再次梗阻及治疗情况、生存情况和死亡原因,分析讨论护理干预对策。结果:154例患者治疗有效率为88.31%;随访发现,再次梗阻者70例,其中接受再治疗者48例;至随访结束,存活者22例,死于肝肾功能衰竭者50例,消化道出血者36例,死于引流相关感染者10例、坏疽者2例,自杀者6例,死因不详者28例。再次梗阻再治疗存活者10例,未再治疗者均死亡;自杀者共6例,其中4例患者术后黄疸为显著改善。分析讨论上述结果并制定出针对性相应护理对策。结论:出院后需加强对患者及家属的引流管护理教育、再梗阻再治疗教育及心理干预,这有利于改善患者的术后生存质量及生存时间。
Objective：To explore the living status and required intensive nursing interventions after percutaneous transhepatie cholangial drainage （PTCD） combined with stent implantation in patients with malignant obstructive jaundice. Methods：Retrospective analysis the clinical data of 154 patients with malignant obstructive jaundice who received PTCD combined with stent implantation in our hospital recently. The reduction of bilirubin and the improvement of jaundice were observed. Re-obstruction, therapeutic conditions, survival conditions and death causes were followed up, and nursing countermeasures were analyzed and discussed after discharge from hospital. Results：Therapeutic effective rate of the 154 patients was 88.31%. The follow-up results indicated that 70 patients had re-ob- struction,in whom 48 received retreatment. Until the end of follow up ,22 patients survived, whereas 50 died of hepatorenal failure,36 of gastrointestinal hemorrhage, 10 of drainage-related infection,2 of gangrene,6 of suicide and 28 of unknown reasons. Of the patients with re-obstruction, 10 survived after re-treatment,while others without retreatment died. Of the 6 patients with suicide,4 patients＇ jaundice was significantly improved after operation. The above results were analyzed and discussed so as to establish corresponding nursing countermeasures. Conclusion：After discharge, nursing education, retreatment education for re-obstruction and psychological interventions should be enhanced for patients and their families, which is beneficial to improving their postoperative quality of life and survival time.
出处
《川北医学院学报》
CAS
2016年第6期907-909,共3页
Journal of North Sichuan Medical College
基金
上海市卫生局青年科研基金项目(20124y030)
关键词
梗阻性黄疸
PTCD
支架
死亡原因
护理
Obstructive jaundice
Percutaneous transhepatic cholangial drainage
Stent
Death cause
Nursing
