18例肝癌TACE术后并发胆道缺血性损伤的原因及护理

目的:探讨肝癌行TACE术后并发胆道缺血性损伤的原因及护理措施。方法:总结18例肝癌TACE术后并发胆道缺血性损伤的资料,分析发现胆道出现缺血性损伤的原因,制定相应的护理措施,采取积极的护理干预,避免或减少此类并发症发生的可能性以及可能造成的严重后果。结果:18例患者均行TACE术3次以上,最多达7次,其中8例术后肝功能失代偿并发黄疸:6例肝硬化、胆管狭窄并黄疸患者穿刺引流后缓解;3倒胆道感染合并上消化道出血患者行保守治疗及胆道外引流术,其中l例死于重症胆道感染引起的败血症:1例因严重胆道感染伴肝功能衰竭死亡。结论:TACE术后并发胆道缺血性损伤的预见性护理干预是此类并发症预后的重要保障,给予患者最佳的治疗和护理,有利于患者的康复。

Reasons and Nursing Care of Postoperative Concurrent Biliary Tract Ischemic Damages of 18 Liver Cancer Cases after TACE

Objective To evaluate the reasons and nursing interventions of postoperative concurrent biliary tract ischemic damages of liver cancer after TACE.Methods The data of 18 liver cancer cases with postoperative concurrent biliary tract ischemic damages after TACE was summarized,the reasons why the biliary tract ischemic damages happened were analyzed, the corresponding nursing measures were formulated,and the active nursing intervention was taken in order to reduce and avoid such complications and the serious consequences.Results The 18 cases were all treated with TACE more than 3 times, up to 7 times,in which 8 cases were postoperative liver function decompensation complicated by jaundice;6 eases were cirrhosis of the liver,bile duct stenosis and jaundice that were relieved by puncture and drainage;3 cases of upper gastrointestinal bleeding merged biliary infections were treated with conservative treatment and drainage outside the biliary tract,including 1 patient died of sepsis caused by severe biliary infections,and 1 patient died of severe biliary infections in combination with hepatic failure.Conclusion The foresight nursing intervention of postoperative concurrent biliary ischemic damages after TACE is the important guarantee of these complications prognosis,and providing the best therapy and nursing for patients is helpful for the recovery of patient.