急诊内镜下血管栓塞术治疗胃静脉曲张出血的护理配合与临床观察  

Nursing cooperation and clinical observation of emergency gastric variceal obliteration in the treatment of gastric variceal bleeding

作　　者：巫织娥[1] 梁艳娉[1] 陈伶君 郑丰平[1] 郭云蔚[1] 

机构地区：[1]中山大学附属第三医院消化内镜中心,广州510630

出　　处：《中华消化病与影像杂志（电子版）》2015年第1期18-21,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的探讨急诊内镜下组织粘合剂注射栓塞术治疗胃静脉曲张破裂出血的护理配合方法与并发症的观察。方法回顾性总结中山大学附属第三医院急诊内镜下应用组织粘合剂(Histoacryl)栓塞治疗251例肝硬化胃静脉曲张破裂出血的手术配合经验和并发症观察的护理体会。结果 251例患者完成534点组织胶注射,护理配合中,注射准备时间为(4.6±2.1)min,仅8例(3.2%)出现止血过程中注射针管堵塞需换管,1例(0.4%)针管打折需中途换管,15例(6.0%)镜头模糊需中途清洁,未出现针头粘滞血管未能退针情况。24 h止血率为100%,早期再出血率1.2%(3/251),总并发症发生率9.2%(23/251)。结论内镜下组织粘合剂治疗胃静脉曲张破裂出血,手术成功率高、见效快。急诊内镜下组织粘合剂注射栓塞的前期准备、注射过程中的密切配合及术后病情观察可明显降低早期再出血率及减少其他并发症的发生。Objective To investigate the methods of care and complications observation of emergency gastric variceal obliteration （ GVO ） with tissue adhesive for the treatment of gastric variceal bleeding （ GVB ） .Methods Two hundred and fifty-one liver cirrhotic patients with GVB treated by emergency GVO with tissue adhesive in our hospital were analyzed retrospectively .The experience of nursing cooperation with doctors and complications observation were summarized .Results Two hundred and fifty-one cases（534 injection points）completed the tissue adhesive injection successfully and operators were satisfied to nursing cooperation.Preparation time for injection was about （4.6 ±2.1）min.Only 8 cases（3.2%）needed to change the needle during operation because of tube blocking ,1 case（0.4%）suffered from needle bending and 15 cases（6.0%） needed to clean the endoscope during operation .No needles stuck the vessels and no severe complications occurred during operation .The hemostatic rate of active bleeding in 24 hours was 100%,the early rebleeding rate was 1.2%（ 3/251 ） and the total complication rate was 9.2%（ 23/251 ） . Conclusions GVO with tissue adhesive is effective and efficient to treat GVB .Comprehensive preparation , close collaboration with doctors and careful observation can significantly reduce the early rebleeding rate and other complications .

关 键 词：胃静脉曲张 出血 栓塞 治疗性 胃镜检查 组织粘合剂 护理 

分 类 号：R472.3[医药卫生—护理学]