ERCP途径治疗高龄患者胆总管巨大结石的临床护理研究

目的探讨经内镜(ERCP途径)治疗高龄患者胆总管巨大结石的可行性和护理操作配合。方法 40例高龄胆总管巨大结石患者完善术前准备,在密切监护下经十二指肠镜先行内镜下逆行胰胆管造影术(ERCP),发现胆总管结石后行内镜下十二指肠乳头括约肌切开术(EST)和机械碎石术(EML)取石,视具体情况留置鼻胆管引流。结果 38例取石成功,取石成功率95.0%,有11例行鼻胆管引流。乳头肌切口创面轻度渗血4例,一过性高淀粉酶血症9例,未发生严重并发症和死亡。结论 ERCP途径(EST联合EML)治疗高龄患者胆总管巨大结石安全有效,娴熟的内镜操作技术、专科护士精心的术前准备、准确迅速的术中配合和监护,以及完善的术后护理是保证治疗成功的重要条件。

Study on clinical nursing of ERCP therapy of large common bile duct stones in elderly patients

Objective To study the feasibility and effect of endoscopic therapy of large common bile duct stones in elderly patients.Methods 40 elderly patients with large common bile duct stones consummated preoperotive preparation,then underwent endoscopic retrograde cholangiopancreatography(ERCP)through duodenoscopy in close monitoring.ALL patiens were treated with endoscopic sphincterotomy(EST)and endoscopic mechanical hthotripsy(EML)after common bile duct stones visualization.Endoscopic nasobiliary drainage was given according the specific circumstances.Results Bile stones of 38 cases were obtained,the success rate was 95.0%,among 11 patients for the treatment of endoscope nasobiliary drainage.Only 4 cases suffered staxis of mild sphincter incision and 9 cases suffered transient hyperamylasemia.No serous complication and death were abserved.Conclusion EST associated with EML are safe and effective in the treatment of common bile duct stones in elderly patients.Skillful endoscopic operation,careful preoperotive preparation,intraoperative close monitoring and perfect postoperative nursing are the keys for the successful operation.