CAJ | 학술논문

目的：分析EPBD胆总管取石术的护理方法和护理效果。方法收集该院2013年4月—2014年4月期间实施EPBD胆总管取石术的患者50例作为研究对象，采用随机分组的方式将患者分为试验组与对照组，每组患者25例。对照组患者采用常规护理模式，试验组在对照组的基础上实施术前心理护理、饮食宣教、术前准备、术中配合、术后常规护理、并发症预防等围手术期护理模式，对两组患者的护理效果进行分析对比。结果研究结果显示，试验组中有23例患者一次取石成功，占总数的92.0%，对照组中有17例患者一次取石成功，占总数的68.0%，试验组一次取石成功率明显高于对照组(P<0.05)；试验组中有3例患者发生并发症，包括鼻胆引流管脱落1例，感染1例，胰腺炎1例，并发症发生率为12.0%；对照组中有10例患者发生并发症，包括鼻胆引流管脱落3例，感染6例，胰腺炎1例，并发症发生率为40.0%，试验组患者并发症发生率明显低于对照组(P<0.05)，两组患者均未出现穿孔、大出血等严重并发症。同时，试验组的手术时间和住院时间明显短于对照组(P<0.05)，术中出血量明显少于对照组(P<0.05)。结论实施EPBD胆总管取石术过程中配合以术前心理护理、饮食宣教、术中配合、术后常规护理、并发症预防等围手术期护理具有良好的临床效果，值得在临床应用上推广。
목적：분석EPBD담총관취석술적호리방법화호리효과。방법수집해원2013년4월—2014년4월기간실시EPBD담총관취석술적환자50례작위연구대상，채용수궤분조적방식장환자분위시험조여대조조，매조환자25례。대조조환자채용상규호리모식，시험조재대조조적기출상실시술전심리호리、음식선교、술전준비、술중배합、술후상규호리、병발증예방등위수술기호리모식，대량조환자적호리효과진행분석대비。결과연구결과현시，시험조중유23례환자일차취석성공，점총수적92.0%，대조조중유17례환자일차취석성공，점총수적68.0%，시험조일차취석성공솔명현고우대조조(P<0.05)；시험조중유3례환자발생병발증，포괄비담인류관탈락1례，감염1례，이선염1례，병발증발생솔위12.0%；대조조중유10례환자발생병발증，포괄비담인류관탈락3례，감염6례，이선염1례，병발증발생솔위40.0%，시험조환자병발증발생솔명현저우대조조(P<0.05)，량조환자균미출현천공、대출혈등엄중병발증。동시，시험조적수술시간화주원시간명현단우대조조(P<0.05)，술중출혈량명현소우대조조(P<0.05)。결론실시EPBD담총관취석술과정중배합이술전심리호리、음식선교、술중배합、술후상규호리、병발증예방등위수술기호리구유량호적림상효과，치득재림상응용상추엄。
Objective To analyze the nursing method and nursing efficacy of EPBD choledocholithotomy. Methods 50 cases un-derwent EPBD choledocholithotomy in our hospital from April 2013 to April 2014 were selected as the subjects and divided into the test group and the control group with 25 cases in each according to the randomization manner. The control group was treated with the routine nursing mode, and the test group was treated with perioperative nursing mode such as preoperative psychological nursing, diet instruction, preoperative preparation, intraoperative cooperation, postoperative routine nursing, prevention of compli-cations and so on. And the nursing efficacy of two groups of patients was analyzed and compared. Results The results of the study showed that, of the test group, there were 23 patients with a successful lithotomy, accounting for 92.0%, while in the control group, there were 17 patients with a successful lithotomy, accounting for 68.0%, the success rate of calculus removed for one time of the test group was significantly higher than that of the control group (P<0.05). Complications occurred in 3 patients in the test group, including nasal biliary drainage tube fall off in 1 case, infection in 1 case, 1 case of pancreatitis, the incidence of complications was 12.0%;Complications occurred in 10 patients in the control group, including nasal biliary drainage tube fall off in 3 cases, in-fection in 6 cases, 1 case of pancreatitis, the incidence of complications was 40.0%, the incidence of complications of the test group was significantly lower than that of the control group (P<0.05). Perforation, massive hemorrhage and other serious complica-tions were not seen in two groups of patients. At the same time, the operation time and hospitalization time of the test group were significantly shorter than those of the control group (P<0.05), introperative blood loss was significantly less than that of the control group (P<0.05). Conclusion Perioperative nursing such as preoperative psychological nursing, diet instruction, intraoperative coop-eration, postoperative routine nursing, prevention of complications and so on given to the patients during the process of EPBD choledocholithotomy can achieve good clinical effect, which is worthy of clinical promotion and application.