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中国临床研究:2022,35(3):441-444
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IQQA®-liver系统辅助肝门部胆管癌ERCP胆管引流术的护理配合
(南京大学医学院附属鼓楼医院消化内镜中心,江苏 南京 210008)
Nursing cooperation of IQQA®-liver system in ERCP biliary drainage for hilar cholangiocarcinoma
(Department of Digestive Endoscopy, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, Jiangsu 210008, China)
摘要
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投稿时间:2021-09-05   网络发布日期:2022-03-20
中文摘要: 目的 探讨建立肝门部胆管癌(HCCA)患者经内镜逆行胰胆管造影(ERCP)引流术的护理配合流程。 方法 回顾性总结2017年1月至2018年12月南京大学医学院附属鼓楼医院内镜中心行IQQA?-liver辅助ERCP胆道引流术的10例HCCA患者的手术配合。 结果 10例HCCA患者以IQQA?-liver辅助行ERCP胆道引流术均顺利完成,引流区肝体积为(627.7±115.7)cm3,经过14~39 d引流后总胆红素含量下降至(59.3±11.8)μmol/L,满足后续外科HCCA根治性切除术术前引流要求,均未出现持续性胆道感染、肝脓肿或其他常见胆道并发症。护理配合:术前参与讨论、对手术目的透彻理解,对IQQA?-liver系统分析患者胆道梗阻需要解除的解剖部位及肿瘤占位情况熟记于心,术前对患者、器械及环境进行充分准备;术中严格执行消毒隔离制度,术中利用泥鳅导丝行肝内胆管超选择插管时,以IQQA?-liver系统分析的三维胆管模型为路标指引,熟练配合医生超选到目标胆管;术后详细交接与观察,使患者能够顺利降低黄疸,为进一步手术治疗创造条件。 结论 IQQA?-liver辅助行HCCA患者ERCP胆管引流可作为可切除手术患者首选的引流方法,护理人员的精准配合亦是手术成功的关键因素之一。
Abstract:Objective To explore the nursing process of endoscopic retrograde cholangiopancreatography (ERCP) drainage in patients with hilar cholangiocarcinoma (HCCA). Methods A retrospective summary of surgical nursing cooperation was made on the 10 HCCA patients undergoing IQQA? (intelligent/interactive qualitative and quantitative analysis) liver system-assisted ERCP in Nanjing Drum Tower Hospital from January 2017 to December 2018. Results IQQA?-liver assisted ERCP biliary drainage was successfully completed in 10 patients. The mean liver volume in the drainage area was (627.7±115.7) cm3. After drainage for 14 to 39 days, the average total bilirubin content decreased to (59.3±11.8) μmol/L, in accord with the requirements of subsequent radical resection of HCCA. There was no persistent biliary tract infection, liver abscess or other common biliary complications. Nursing cooperation focused on participating in preoperative discussion, thorough understanding of the operation and IQQA?-liver system in analyzing the anatomical sites and tumor space of patients with biliary obstruction, fully preparing surgical instruments and environment and preoperative nursing of the patients. During the operation, the disinfection and isolation system was strictly implemented, and superselecting the target bile duct was performed based on skillfully cooperating with doctors when Radifocus guide wire was used for intrahepatic bile duct superselective intubation with the guide sign of three-dimensional bile duct model analyzed by IQQA? -liver system. The detailed postoperative handover and observation are helpful to reduce the jaundice and create conditions for further surgical treatment.
文章编号:     中图分类号:R472.3    文献标志码:B
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引用文本:
周晓亮,展薇,李文婷.IQQA®-liver系统辅助肝门部胆管癌ERCP胆管引流术的护理配合[J].中国临床研究,2022,35(3):441-444.

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