双腔T管窦道造影预防拔管后胆漏的临床分析及护理体会  

作　　者：魏桂菊 胡芳 曾妙弟 

机构地区：[1]深圳市观澜人民医院普外科,广东深圳518110

出　　处：《现代临床护理》2009年第2期44-45,8,共3页Modern Clinical Nursing

摘　　要：目的探讨双腔T管窦道造影预防拔管后胆漏的临床疗效并总结护理要点。方法将125例患者随机分为2组,63例患者实行胆道T管外引流,拔T管前经双腔T管窦道胆道造影(治疗组),62例患者采用常规置管,拔管前行非窦道胆道造影(对照组)。两组患者均采取包括心理护理在内的多种护理措施,比较两组平均拔管时间和并发症发生率。结果对照组患者平均拔管时间为36.2d,拔T管后发生胆漏6例,占9.68%;治疗组患者平均拔管时间为16.2d;拔管后2例发生胆漏,占3.17%;治疗组的拔管时间与胆漏发生率均明显低于对照组,两组比较具有统计学差异(均P<0.05)。结论拔T管前经双腔T管窦道胆道造影可客观地反映窦道的形成情况,同时辅以合理的护理,可有效地防止拔管后胆漏的发生,值得临床推广应用。Objective To investigate the clinical curative effect of double-lumen T-tube placement in choledochography to prevent biliary fistula after extubation. Methods 125 patients was randomized into 2 groups： 63 eases in the treatment group undergoing choledochostomy with double-lumen T-tube drainage before extubation and another 62 cases in the control group with conventional placement of tube. The nursing measures including mental care were taken for the patients in both groups. Results The average indwelling duration of T-tubes were 36.2 d in control group and 16.2 d in treatment group. In control group, withdrawal of T-tubes caused 6 cases of biliary fistula （9.68%）, while in the treatment group, there were 2 cases （3.17%）. Comparatively, the indwelling duration of T-tubes and the incidence of biliary fistula of the treatment group were significantly lower than those of control group （P 〈 0.05）. Conclusions Choledochography before withdrawal of doublelumen T-tube can present the formation of sinus tract. The appropriate nursing measures can effectively prevent occurrence of the biliary fistula.

关 键 词：双腔T管 胆漏 胆道造影 护理 

分 类 号：R473.6[医药卫生—护理学]