治疗性ERCP术后迟发性出血的早期发现及内镜下治疗的护理配合  

Early detection of delayed bleeding after therapeutic ERCP and nursing cooperation for endoscopic treatment

作　　者：刘君君 

机构地区：[1]射阳县人民医院,江苏射阳224300

出　　处：《医学前沿》2025年第2期151-152,共2页Frontiers of Medicine

摘　　要：目的:探讨治疗性内镜逆行胰胆管造影术(ERCP)后迟发性出血的早期发现及内镜下治疗的护理配合策略。方法:回顾性分析2022年1月-2024年11月期间在本院行治疗性ERCP术的40例患者资料,分析早期发现方法、内镜下治疗方法以及护理配合,观察患者止血情况。结果:40例行治疗性ERCP术患者中,发生迟发性出血共19(47.50%)例,其中12(63.16%)例患者在出血后24h内被发现,其余7(36.84%)例在24h-7d内被发现。早期发现组与延迟发现组相比,再出血率更低、住院时间更短,对比差异显著(P<0.05);19例迟发性出血患者经止血处理后均成功止血,其中局部注射止血7(36.84%)例、内镜氩离子凝固术止血6(31.58%)例、金属止血夹钳夹止血4(21.05%)例、金属止血夹结合注射止血2(10.53%)例。结论:加强对治疗性ERCP术后患者的监测,结合临床表现、实验室及影像学检查,可实现迟发性出血的早期发现。内镜下治疗配合科学的护理干预可提高止血成功率,有利于患者术后康复,临床需给予足够重视。Objective:To explore the early detection of delayed bleeding after therapeutic endoscopic retrograde cholangiopancreatography(ERCP)and the nursing cooperation strategy for endoscopic treatment.Method:A retrospective analysis was conducted on the data of 40 patients who underwent therapeutic ERCP surgery in our hospital from January 2022 to November 2024.Early detection methods,endoscopic treatment methods,and nursing cooperation were analyzed,and the hemostasis of patients was observed.Result:Among 40 patients undergoing therapeutic ERCP,a total of 19(47.50%)experienced delayed bleeding,of which 12(63.16%)were detected within 24 hours after bleeding,and the remaining 7(36.84%)were detected within 24-7 days.Compared with the delayed detection group,the early detection group had a lower rebleeding rate and shorter hospital stay,with significant differences(P<0.05);After hemostasis treatment,all 19 patients with delayed bleeding were successfully stopped,including 7 cases(36.84%)of local injection hemostasis,6 cases(31.58%)of endoscopic argon plasma coagulation hemostasis,4 cases(21.05%)of metal hemostatic clamp hemostasis,and 2 cases(10.53%)of metal hemostatic clamp combined with injection hemostasis.Conclusion:Strengthening monitoring of postoperative patients undergoing therapeutic ERCP,combined with clinical manifestations,laboratory and imaging examinations,can achieve early detection of delayed bleeding.Endoscopic treatment combined with scientific nursing interventions can improve the success rate of hemostasis and facilitate postoperative recovery of patients.Sufficient attention should be given in clinical practice.

关 键 词：治疗性ERCP术 迟发性出血 早期发现 内镜下治疗 护理配合 

分 类 号：R47[医药卫生—护理学]