带气囊导尿管在重症急性胆道出血的术中应用  

The application by using Foley catheter in acute hemorrhage of biliary tract during surgical operation

作　　者：严剑山 黄秀隆 王冬冬[1] 

机构地区：[1]福建省建瓯市立医院外二科,353100

出　　处：《中国现代医药杂志》2009年第1期30-32,共3页Modern Medicine Journal of China

摘　　要：目的探讨急性胆道出血的原因、治疗经验及应急抢救。方法回顾性分析自2000年1月以来我院收治的10例胆道出血患者的临床资料及手术处理情况。结果术后再出血3例,全组病例经治疗后未再出血,无死亡。结论急性胆道出血主要原因是胆道结石、感染、外伤及医源性因素引起的。出血量不大时可采用抗感染、应用止血剂、含去甲肾上腺素盐水或稀释双氧水冲洗、引流胆道等治疗,出血量大时可适当选用肝动脉插管造影栓塞、肝动脉或分枝结扎术、出血的肝叶(段)切除术、胆道镜下电凝止血及术中采用带气囊导尿管堵压止血。采用带气囊导尿管堵压止血,简单有效、创伤小,特别适用于全身情况差的老年或重症胆道出血患者。Objective To study and summarize the cause,therapeutic experience and emergency rescue of acute hemobilia.Methods The clinical data and the experience during the treatment of 10 cases of acute hemobilia from January 2000 were analyzed retrospectively.Results 3 cases were re-bleeding after operative.All cases were cured.Conclusion The main cause of acute hemobilia were calculus and infection of biliary tract,trauma of biliary tract and the therapeutic cause.An-ti-infection by using hemostatic agent,flushing and drain of biliary tract by using salt solution which contain noradrenalin or hy-drogen peroxide can be used,when the volume of bleeding was not too large.In massive hemorrhage,the following treatment can be used：hepatic arteriography and embolism,ligation of hepatic artery and its branch,resection of hemorrhagic lobes or seg-ments of liver,electric coagulation under choledochoscope and hemostasia by using Foley catheter.Hemostasia by using Foley catheter is a simple and effective method which has micro-injury,especially for the patients who with elder,weak and serious hemostasia.

关 键 词：急性胆道出血 治疗经验 带气囊导尿管 患者 临床应用 

分 类 号：R657.4[医药卫生—外科学]