恶性梗阻性黄疸PTCD治疗后患者带管出院的导管维护状况及影响因素分析  

Catheter maintenance status and influencing factors of patients with malignant obstructive jaundice after percutaneous transhepatic cholangio drainage(PTCD)treatment

作　　者：陈聪英[1] Chen Congying(Department of Gastroenterology,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院消化内科,473000

出　　处：《国际医药卫生导报》2021年第2期269-272,共4页International Medicine and Health Guidance News

摘　　要：目的观察经皮肝穿刺胆道引流术(PTCD)治疗后恶性梗阻性黄疸患者带管出院的导管维护状况,分析导管维护状况不佳的影响因素,为后续改善导管维护状况提供依据。方法回顾分析2018年3月至2020年3月本院完成PTCD治疗后带管出院的80例恶性梗阻性黄疸患者临床资料,观察患者出院1个月不良事件与导管相关并发症发生情况,根据患者是否发生不良事件与导管相关并发症分为导管维护不佳和导管维护良好;比较两组基线资料,并通过单因素与多因素分析找出恶性梗阻性黄疸PTCD治疗后带管出院导管维护不佳的影响因素。结果PTCD治疗后带管出院恶性梗阻性黄疸患者导管维护不佳发生率为26.25%,其中,胆道出血、伤口感染发生率最高;经单因素与多项logistic回归分析检验结果显示,皮肤过敏、未预防性使用抗生素、文化水平低、抑郁/焦虑、自我护理能力低为PTCD治疗后带管出院恶性梗阻性黄疸患者导管维护状不佳的影响因素(均OR>1,P<0.05)。结论PTCD治疗后带管出院恶性梗阻性黄疸患者导管维护状况可能受皮肤过敏、未预防性使用抗生素、文化水平低、抑郁/焦虑、自我护理能力低等因素影响,临床应重视有上述风险因素的患者,并针对性给出合适干预方案,可能对改善患者导管维护状况有积极意义。Objective To observe the status of catheter maintenance in patients with malignant obstructive jaundice after percutaneous transhepatic cholangio drainage(PTCD)treatment,and analyze the influencing factors of poor catheter maintenance,so as to provide the basis for the improvement of catheter maintenance.Methods The clinical data of 80 patients with malignant obstructive jaundice who were discharged with catheter after PTCD treatment in our hospital from March 2018 to March 2020 were retrospectively analyzed.The adverse events and catheter-related complications were observed within one month after discharge.According to whether adverse events and catheter-related complications occurred or not,the patients were divided into poor catheter maintenance group and good catheter maintenance group.The baseline data of the two groups were compared,and univariate analysis and multivariate analysis were used to find out the influencing factors of poor catheter maintenance of patients with malignant obstructive jaundice after PTCD treatment.Results The incidence of poor catheter maintenance of patients with malignant obstructive jaundice after PTCD treatment was 26.35%,among which the incidence of hemobilia and wound infection were the highest.The results of univariate analysis and multivariate logistic regression analysis showed that skin allergy,non prophylactic use of antibiotics,low educational level,anxiety/depression,and low self-care ability were the influencing factors of poor catheter maintenance of patients with malignant obstructive jaundice after PTCD treatment (allOR>1, P<0.05). Conclusion The catheter maintenance status of patients with malignantobstructive jaundice after PTCD treatment may be affected by skin allergy, non prophylactic use ofantibiotics, low educational level, anxiety / depression, low self-care ability, etc.

关 键 词：恶性梗阻性黄疸 经皮肝穿刺胆道引流术 导管维护状况 影响因素 

分 类 号：R473.73[医药卫生—护理学]