胰腺假性囊肿经内镜引流治疗的护理探讨

目的探讨胰腺假性囊肿经胰管支架或鼻胰管引流的护理价值。方法采用回顾性调查对31例行内镜下经十二指肠乳头胰管内外引流术的胰腺假性囊肿患者进行分析,探讨内镜下经十二指肠乳头胰管内引流及有效的护理对胰腺假性囊肿的治疗作用。结果 31例胰腺假性囊肿经内镜引流（ERCPO）32例（次）,其中鼻胰管引流（ENPD）8例;胰管支架（ERPD）10例;ENPD＋ERPD13例。术后出现囊肿感染4例,感染率13%;2例转外科手术治疗,其中1例因胰腺假性囊肿多分隔,另外1例因引流液中查到异型细胞,转手术切除;囊肿复发1例,再次给予ERPD引流后治愈;胰腺假性囊肿残腔形成1例。无出血、穿孔、死亡等并发症发生。胰管支架放置至囊肿消失时间平均3mon,平均住院40.6d。结论内镜经乳头引流治疗交通性胰腺假性囊肿是一种确切有效的治疗方法,而术前、术中、术后护理措施是保证手术顺利进行及手术疗效的必备条件。

Disscussion of the care after pancreatic pseudocyst endoscopic drainage treatment

Objective To investigate the care of the drainage of pancrearic pseudocys via the panerearic duct stents or nasal dust. Methods Retrospective analysis of 31 cases of pancreatic duct internal and external drainage for pancreatic pseudocyst with the endoscopy, explore the therapeutic effect of care to the pancreatic pseudocys with the endoscopic duo- denal pancreatic duct drainage. Results In 31 patients for ERCP 32 times, including nasal pancreatic drainage（ENPD）8 eases, 10 cases of panceatic duct stent（ERPD） ;ENPD＋ERPD 13 cases. Postperative cyst infection in four cases,the in- fection rate of 13 %two cases of surgical treatment , one cases of pancreatic pesdoeyst more than separated,and 1 cases found due to the drainage shaped cells, switch to surgical resectiom cyst recurrence 1 case. No bleeding, perforation,death and other complications occurred. Duct stent placement to the cyst disappeared average time 3mon, average hospital stay was 40.6d. Conclusion and effective treatment, Endoscopic nipple drainage in the treatment of communicating pancreatic pesudocyst is a precise effective preoperative,intraoperative, and postoperative care measures is to ensure that the prerequisites for the smooth operation and surgery.