胆总管探查术中采用胆道镜直视检查确认是否通畅对患者的影响  

Influence of the smooth of bile duct examined by choledochoscope during the common bile duct exploration on patients

作　　者：任瑞芳[1] 林秀红[1] 张小莉[1] 

机构地区：[1]温州医学院附属第三医院外一科,瑞安325200

出　　处：《中国实用护理杂志（下旬版）》2008年第5期8-10,共3页Chinese Journal of Practical Nursing

基　　金：温州市科技局科技计划项目（Y20070163）

摘　　要：目的探讨胆总管探查术中采用胆道镜直视检查确认胆总管下端是否通畅对患者胆道流变学指标的影响。方法将择期行胆总管探查的40例患者随机分为对照组和实验组各20例，对照组术中采用常规探查确认胆总管下端是否通畅，实验组术中采用胆道镜直视检查确认胆总管下端是否通畅。监测2组患者术后72h内的24h T管引流量，术后胆总管压力、流量、流量阻力及引流液淀粉酶含量。结果对照组在术后第2天T管引流量增加，胆总管压力明显增高，流量减低，流量阻力加大。引流液淀粉酶含量降低，与实验组比较，差异有统计学意义（P〈0．05）。结论若术中避免胆总管下端损伤性探查，术后72h内监测胆总管压力、流量及流量阻力可能有助于确定T型管护理时早期夹管时机。Objective To discuss the influence of the smooth of bile duct examined by choledochoscope during the common bile duct exploration on the biliary tract rheology. Methods Forty patients who were to undergo common bile duct exploration were divided, into the control group and the test group with 20 cases in each gronp.The smooth of the distal common bile duct was examined by choledochoscope in the test group while by routine method in thecontrol greup.The T tube drainage volume for 24 h,the pressure,flow volume and resistance of common bile duct and amylase content of drainage were monitored in the two groups within 72 h. Results The T tube drainage volume of the second day increased,the pressure and the resistance of the common bile duct decreased,the flow volume and amylase content of drainage reduced in the control group,which had statistical difference from those of the test group （P 〈 0.05）. Conclusion Avoidance of damaging examination of the distal common bile duct, monitoring of the pressure,flow volume and resistance of the common bile duct within 72 h after operation contributed to the confirmation of the time for clamping T tube early.

关 键 词：胆总管探查术 T型管引流 胆道流变学 

分 类 号：R657.4[医药卫生—外科学] R657.42[医药卫生—临床医学]