经T管胆道测压在胆总管探查术后早期夹管中的临床应用  

Clinical application of biliary pressure measurement and early T-tube closure

作　　者：刘明奇 田明国[1] 张少亚 杨勇[1] 贾东 辛国军[1] LIU Ming-qi;TIAN Ming-guo;ZHANG Shao-ya;YANG Yong;JIA Dong;XIN Guo-jun(Department of Hepatobiliary Surgery,the People's Hospital of Ningxia Autonomous Region,Yinchuan,Ningxia,750002)

机构地区：[1]宁夏回族自治区人民医院肝胆外科,宁夏银川750002

出　　处：《临床普外科电子杂志》2017年第4期9-12,共4页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的探讨胆总管探查术后胆道压力的测定对早期夹闭T管的影响。方法胆总管探查T管引流术后每天经T管测量胆道压力,当压力值≤14cm H2O时行早期夹管,并观察患者夹管后的反应。结果行胆道测压并早期夹管30例,胆道压力值≤14cm H2O时的术后时间为术后第2天15例,第3天8例,第4天4例,第5天2例,1例于术后第7天压力仍高于20cm H2O。30例患者术后T型管造影均显示胆管通畅,未见结石残留、胆管狭窄及胆道梗阻,2例造影后出现低热,1例夹闭T管后出现胆漏,1例拔除T管1个月后发现胆管残余结石,有5例出现轻微上腹部胀痛不适,1例患者出现明显腹痛且伴有恶心、呕吐症状。结论胆总管探查T管引流术后胆道压力的测量有利于指导术后早期夹闭T管。Objective To investigate routine biliary pressure measurement for early closure of T-tube after common bile duct exploration.Methods Biliary pressure was measured and early closure of T-tube was done when the pressure is≤14cmH2O after common bile duct exploration.Clinical effect was observed.Results In 30 patients after common bile duct exploration,the postoperative day of biliary pressure measured≤14cmH2O was 15 cases on Day2,8 on Day3,4 on Day4 and 2 on Day5.One case had pressure still higher than 20cmH2O on the 7th day after surgery.Postoperative T-tube cholangiography was performed on 30 patients with patent bile flow and no residual stones,no bile duct stricture and biliary obstruction was found.Two patients had slight fever after cholangiography,one patient had a bile leak after clamping the T-tube,and another was found a residual stone one month after T-tube removal.Five patients had minor upper abdominal pain and discomfort and one patient developed obvious abdominal pain accompanied by nausea and vomiting.Conclusion Measurement of biliary pressure can direct early closure of T-tube after surgery.

关 键 词：胆总管探查 经T管胆道测压 早期夹管 快速康复 

分 类 号：R657.4[医药卫生—外科学]