复杂肝内胆管结石病的围手术期护理

目的 探讨肝内胆管结石围手术期的护理要点.方法 回顾性分析1998～2005年我院收治复杂肝内胆管结石153例的临床、护理资料,对其术前全身及营养情况做详细评估,重点检查心肝、肺、肾及血液系统功能,做好心理护理;术后密切观察生命体征及病情变化,保证有效循环血量,防治低血压;保持各引流管通畅,加强基础护理及术后并发症的观察及护理.结果 该153例复杂肝内胆管结石患者均做了肝叶切除术,无1例手术死亡,153例中发生术后并发症37例(24.2%),围手术期死亡4例(2.62%).结论 做好围手术期的护理尤其是增强术后的护理观察,提高术后护理质量,从而巩固手术疗效.

Clinical nursing analysis of 153 complicated intrahepatic cholelithiasis patients

Objective To study the important points of clinical nursing of complicated intrahepatic cholelithiasis. Methods 153 patients with complicated intrahepatic cholelithiasis were analyzed including operation modality, postoperative complication, residual stone and nursing data. Results Postoperative complications were occurred in 37 cases (24. 2% ), mortality was 2. 62%, limited intrahepatic bile duct was 80.4%. A follow up of 0. 5 to 10 years was achieved in 81 patients (53.0%), with excellent or good result in 77. 8%, residual stone in 21.0%, and stone recurrence in 8. 7%. Conclusions The combined hepatic resection and other operation are ideal and effective surgical method to treat complicated intrahepatic cholelithiasis.