导管固定贴在经皮肝穿胆道引流术中固定引流管的疗效评价

Evaluation of the Therapeutic Effect of Catheter Fixation Patches in Fixing Drainage Tubes during Percutaneous Transhepatic Cholangiography Drainage

摘要: 目的：在梗阻性黄疸行经皮肝穿胆道引流术的患者中，评估导管固定贴对比传统缝线固定引流管的效果。方法：回顾性分析2023年1月至2024年12月在安徽医科大学第二附属医院介入科因梗阻性黄疸行PTCD术患者100例，其中48例患者的PTCD管进行缝线固定，52例患者行导管固定贴固定PTCD管，比较两组患者对术后胆道引流管脱出发生率，管道引流不畅发生率，引流管口周围皮肤刺激性皮炎发生率，患者引流管处疼痛情况，引流管固定装置护理时间及日均护理费用进行评估，结果：导管固定贴组相比对照组术后胆道引流管脱出发生率(11.53% vs 6.25%, P = 0.491)，未见明显统计学意义，管道引流不畅发生率低(3.85% vs 16.67%, P = 0.045)，引流管口周围皮肤刺激性皮炎发生率低(5.77% vs 29.17%, P = 0.003)，引流管周围皮肤疼痛持续时间短[(2.15 ± 0.23) d vs (4.21 ± 1.49) d, P = 0.004]，引流管固定装置日均护理时间短[(1.26 ± 0.33) min vs (2.18 ± 0.29) min, P = 0.025]，引流管固定装置日均护理费用低[(3.68 ± 1.03)元 vs (5.23 ± 1.25)元，P = 0.013]。结论：导管固定贴固定引流管相比对照组存在更加良好的护理效果，病人的不适感降低，值得临床推广。

Abstract: Objective: To evaluate the effect of catheter fixation patches compared with traditional suture fixation of drainage tubes in patients with obstructive jaundice undergoing percutaneous transhepatic cholangiography drainage. Method: A retrospective analysis was conducted on 100 patients who underwent PTCD surgery due to obstructive jaundice in the Interventional Department of the Second Affiliated Hospital of Anhui Medical University from January 2023 to December 2024. Among them, the PTCD tubes of 48 patients were fixed with sutures, and the PTCD tubes of 52 patients were fixed with catheter fixation patches. The incidence of postoperative cholangiography drainage tube protrusion was compared between the two groups. The incidence of poor drainage of the pipeline, the incidence of skin irritant dermatitis around the drainage tube opening, the pain at the drainage tube site of the patients, the nursing time of the drainage tube fixation device and the average daily nursing cost were evaluated. Results: The incidence of cholangiography drainage tube protrusion after surgery in the catheter fixation patch group compared with the control group (11.53% vs 6.25%, P = 0.491). No significant statistical significance was observed. The incidence of poor drainage of the drainage tube was low (3.85% vs 16.67%, P = 0.045), and the incidence of irritating dermatitis of the skin around the drainage tube opening was low (5.77% vs 29.17%, P = 0.003). The duration of skin pain around the drainage tube was short [(2.15 ± 0.23) d vs (4.21 ± 1.49) d, P = 0.004], and the average daily care time of the drainage tube fixation device was short [(1.26 ± 0.33) min vs (2.18 ± 0.29) min, P = 0.025]. The average daily maintenance cost of the drainage tube fixation device was low [(3.68 ± 1.03) yuan vs (5.23 ± 1.25) yuan, P = 0.013]. Conclusion: Compared with the control group, the catheter fixation patch for fixing the drainage tube has a better nursing effect, reducing the patients’ discomfort. It is worthy of clinical promotion.