1例肝门胆管癌患者经皮肝穿刺胆管引流术后并发胆汁性腹膜炎患者的护理
Nursing Care of a Patient with Cholestatic Peritonitis Complicated by Percutaneous Nhepatic Perforation Biliary Drainage in a Patient with Hepatoportal Cholangiocarcinoma
DOI: 10.12677/acm.2025.1551482, PDF,   
作者: 范 蕾, 褚嘉帅：黑龙江中医药大学研究生院，黑龙江 哈尔滨；白 静：黑龙江中医药大学附属第三医院胃肠镜外科，黑龙江 哈尔滨；张 敏*：黑龙江中医药大学附属第三医院纪委办公室，黑龙江 哈尔滨
关键词: 肝门胆管癌；胆管引流术；胆汁性腹膜炎；护理；Hepatocellular Carcinoma of the Bile Ducts； Bile Duct Drainage； Cholestatic Peritonitis； Nursing Care
摘要: 总结对1例胆管癌患者经皮肝穿刺胆管引流术后并发胆汁性腹膜炎患者的护理经验。其主要护理要点包括：禁食、胃肠减压，维持液体平衡，密切监测生命体征和组织灌注量的改变，严格管理渗液并观察引流管畅通情况，注意腹部体征变化，预防感染，稳定病人情绪，给予心理支持，做好围术期相关知识指导与营养支持，加速患者的康复，经过精心治疗和护理，患者逐渐好转，康复出院。
Abstract: To summarise the experience of caring for a patient with cholestatic peritonitis complicating percutaneous percutaneous bile duct drainage in a patient with cholangiocarcinoma. The main nursing points include: fasting, gastrointestinal decompression, maintaining fluid balance, close monitoring of vital signs and changes in tissue perfusion, strict management of exudate and observation of drainage patency, resting on changes in abdominal signs, prevention of infection, stabilisation of the patient’s emotional value to give psychological support, and perioperative guidance and nutritional support to accelerate the patient’s rehabilitation. After careful treatment and care, the patient gradually improved and was discharged from hospital.
文章引用：范蕾, 褚嘉帅, 白静, 张敏. 1例肝门胆管癌患者经皮肝穿刺胆管引流术后并发胆汁性腹膜炎患者的护理[J]. 临床医学进展, 2025, 15(5): 1201-1205. https://doi.org/10.12677/acm.2025.1551482

参考文献

[1] 肖鸣, 项灿宏. 肝门部胆管癌术前预留肝叶储备功能的评估与改善[J]. 中国普通外科杂志, 2024, 33(12): 1958-1966.
[2] Waseem, D. and Tushar, P. (2017) Intrahepatic, Perihilar and Distal Cholangiocarcinoma: Management and Outcomes. Annals of Hepatology, 16, 133-139. [Google Scholar] [CrossRef] [PubMed]
[3] 曹莉明, 张勇学, 崔进国, 等. DSA联合MRCP融合导航经皮肝穿刺胆管引流治疗高位恶性胆道梗阻的临床效果[J]. 医学影像学杂志, 2024, 34(11): 78-81.
[4] 薛芳芳. 胆管癌经皮肝穿刺胆管引流术后并发症的护理干预[J]. 婚育与健康, 2023, 29(16): 142-144.
[5] 张捷, 刘颖斌. 肝内胆管癌外科治疗进展[J]. 中国实用外科杂志, 2023, 43(9): 1070-1076.
[6] 李云峰. 腹腔镜胆囊摘除术后胆漏的相关因素分析[J]. 临床研究, 2018, 26(3): 9-10+12.
[7] 操海宝. 腹腔镜胆道探查术后拔除T管致胆汁性腹膜炎的思考[J]. 安徽医专学报, 2021, 20(4): 38-40.
[8] 梁力建. 胆道外科手术常见的并发症及处理[J]. 腹部外科, 2022, 35(1): 1-4.
[9] 柴乃俊, 高鹏, 杨晓军, 等. 肝胆外科术后胆漏73例治疗分析[J]. 中华肝脏外科手术学电子杂志, 2020, 9(1): 58-61.
[10] 李可为, 施维锦. 拔T管后胆漏、腹膜炎[J]. 中国实用外科杂志, 2002, 22(7): 41-43.
[11] 梁力建. 胆道外科手术常见的并发症及处理[J]. 腹部外科, 2022, 35(1): 1-4.
[12] 姚亭, 高亚南, 徐涯鑫, 等. 住院患者肠外营养支持并发症预防的最佳证据总结[J]. 中华护理杂志, 2024, 59(11): 1360-1367.
[13] 杨静怡, 杨晓旸, 肖艳艳, 等. 1例食管癌术后感染性休克合并胸腔-气管-纵隔-胃多重瘘患者的护理[J]. 当代护士(下旬刊), 2023, 30(10): 143-146.
[14] 孙金洪, 卢柳衣, 潘万龙. 莨菪提取物中生物碱抗肿瘤作用机理的研究进展[J]. 大众科技, 2023, 25(10): 61-64+60.
[15] Harmankaya, M., Oreskov, J.O., Burcharth, J., et al. (2020) The Impact of Timing of Antibiotics on In-Hospital Outcomes after Major Emergency Abdominal Surgery. European Journal of Trauma and Emergency Surgery, 46, 221-227. [Google Scholar] [CrossRef] [PubMed]
[16] 朱永强, 汪涛, 程龙, 等. 弥漫性胆汁性腹膜炎的序贯式微创化治疗研究[J]. 广东医学, 2018, 39(12): 1823-1826.

为你推荐