联合肝脏离断和门静脉结扎二步肝切除术治疗巨大肝癌的护理配合  

Nursing cooperation management for associating liver partition and portal vein ligation for staged hepatectomy in the treatment of giant hepatocellular carcinoma

作　　者：童志兰[1] 廖源[2] 罗景和[1] 张金 张琪媚 Tong Zhilan;Liao Yuan;Luo Jinghe;Zhang Jin;Zhang Qimei(Operating Room,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China;Guangzhou University of Chinese Medicine,Guangzhou 510006,China)

机构地区：[1]广东省中医院手术室,广州510120 [2]广州中医药大学,广州510006

出　　处：《国际医药卫生导报》2024年第4期666-669,共4页International Medicine and Health Guidance News

基　　金：广东省中医药管理局科研项目(20222067)。

摘　　要：目的总结巨大肝癌患者行腹腔镜下联合肝脏离断和门静脉结扎二步肝切除术(ALPPS)的护理配合经验。方法本研究为回顾性研究。选取广东省中医院2018年1月至2023年1月的11例巨大肝癌患者为研究对象,11例患者均为男性,年龄(54.00±11.38)岁,均实施腹腔镜ALPPS。手术过程中护理管理重点在于术前评估、用物准备、术中控制出血的精准配合及贯彻无瘤原则。结果11例患者术后恢复良好,未出现肝创面出血、胆漏、二次手术等情况。一期术后住院天数为(10.27±2.87)d,二期术后住院天数为(12.36±3.50)d。结论ALPPS难度大,做好术前访视与评估、用物准备、控制出血与止血的精准护理管理是提高手术效果及患者手术安全的重要保障。Objective To summarize the experiences of nursing cooperation for laparoscopic associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)in the treatment of giant hepatocellular carcinoma.Methods This was a retrospective study.A total of 11 patients with giant hepatocellular carcinoma from Guangdong Provincial Hospital of Chinese Medicine from January 2018 to January 2023 were selected for the study,all male,aged(54.00±11.38)years,and all of them underwent laparoscopic ALPPS.Nursing cooperation during surgery focused on preoperative assessment,materials preparation,precise cooperation for intraoperative bleeding control,and implementation of tumor-free principle.Results The 11 patients had good postoperative recovery without complications such as hepatic trauma bleeding,bile leakage,or secondary surgery.The length of hospital stay was(10.27±2.87)d after the first stage operation and(12.36±3.50)d after the second stage operation.Conclusions ALPPS is difficult,especially under laparoscope.Good preoperative visit and assessment,materials preparation,and precise nursing cooperation for controlling bleeding and hemostasis are important guarantees to improve the surgical effect and ensure the patients'surgical safety.

关 键 词：肝癌 巨大 联合肝脏离断和门静脉结扎二步肝切除术 护理配合 

分 类 号：R473.73[医药卫生—护理学]