内镜下十二指肠乳头括约肌切开术治疗老年胆总管结石的手术配合及护理

目的 探讨内镜下十二指肠乳头括约肌切开术(EST)治疗胆总管结石的效果及护理要点.方法 回顾性分析73例行EST取石术治疗老年胆总管结石患者的临床资料,术前对患者进行耐心细致的心理护理及检查准备工作,术中严密观察患者生命体征变化及护理,术后进行呼吸道的护理、心血管疾病及糖尿病的护理、疼痛护理、并发症的观察处理.结果 73例患者取石成功69例,成功率为94.5%;术后并发高淀粉酶血症8例,经保守治疗临床痊愈;2例出现发热、白细胞计数增高,使用有效抗生素治疗后好转;无穿孔、切口出血及死亡病例发生.结论 EST治疗胆总管结石,疗效好,风险小;通过细心的观察与护理,减少了老年患者并发症的发生,促进了患者的早日康复,提高了老年患者的生活质量.

Surgery coordination and nursing of EST for treating elderly patients with choledocholithiasis

Objeetive To investigate the clinical effects and nursing interventions of endoscopic sphincterotomy(EST)for treating elderly patients with choledocholithiasis.Methods The clinical data of 73 cases of patients operated by EST were retrospectively analyzed.Before surgery the psychological nursing,examination and preparation were meticulously performed,the changes of vital signs and nursing were closely observed during surgery,the respiratory tract nursing,cardiovascular disease and diabetes nursing,pain nursing and complications treatment were performed after surgery.Results There were 69cases of 73 patients were successful,the success rate was 94.5%;8 cases of concurrent hyperamylasemia were given conservative treatment and had clinical recovery;2 cases of fever occurred and white blood cell count elevated and were treated by effective antibiotic treatment;there was no perforation,wound bleeding and death.Conclusions Using the EST to treat the choledocholithiasis of elderly patients has good clinical effects and low risk;through careful observation and nursing,can reduce complications,promote the patients'early recovery and improve quality of life of elderly patients with choledocholithiasis.