[1]王淑萍,张倩,许丽君,等.内镜下治疗十二指肠乳头括约肌切缘出血的护理配合技巧[J].解放军护理杂志,2022,39(01):88-89+96.[doi:10.3969/j.issn.1008-9993.2022.01.022]
　WANG Shuping,ZHANG Qian,XU Lijun,et al.Nursing Cooperation Skill in Endoscopic Treatment of Pro-Endoscopic Sphincterotomy Hemorrhage[J].Nursing Journal Of Chinese People’s Laberation Army,2022,39(01):88-89+96.[doi:10.3969/j.issn.1008-9993.2022.01.022]
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内镜下治疗十二指肠乳头括约肌切缘出血的护理配合技巧
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《解放军护理杂志》[ISSN:2097-1826/CN:31-3186/R]

卷:
39
期数:
2022年01期
页码:
88-89+96
栏目:
专科护理
出版日期:
2022-01-15

文章信息/Info

Title:
Nursing Cooperation Skill in Endoscopic Treatment of Pro-Endoscopic Sphincterotomy Hemorrhage
文章编号:
1008-9993(2022)01-0089-03
作者:
王淑萍1; 张倩1; 许丽君1; 王坤可1; 刘延廷1; 张世杰1; 叶志霞2
(1.海军军医大学第三附属医院 内镜科,上海 200438; 2.海军军医大学第三附属医院 护理部)
Author(s):
WANG Shuping1; ZHANG Qian1; XU Lijun1; WANG Kunke1; LIU Yanting1; ZHANG Shijie1; YE Zhixia2
(1.Department of Endoscopy,The Third Hospital Affiliated to Naval Military University,Shanghai 200438,China; 2.Department of Nursing,The Third Hospital Affiliated to Naval Military University)
关键词:
内镜下治疗;  十二指肠乳头括约肌切缘出血;  护理
Keywords:
Endoscopic treatment;  pro-endoscopic sphincterotomy hemorrhage;  nursing cooperation
分类号:
R473
DOI:
10.3969/j.issn.1008-9993.2022.01.022
文献标志码:
A
摘要:
目的 探讨内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)术后十二指肠乳头括约肌切缘出血内镜下止血治疗的操作护理配合与技巧。方法 纳入2011年3月至2020年2月在我院内镜中心行ERCP治疗后出现十二指肠乳头括约肌切缘或周围出血并行内镜下止血治疗的患者77例,根据出血位置及出血量选用合适的止血方法,通过术中精准的医护配合及熟练的护理操作配合技巧,分析内镜下止血治疗的成功率及安全性。结果 所有患者均行内镜下止血治疗,其中76例成功止血,1例经内镜止血治疗后仍有活动性出血表现,经数字减影血管造影技术(digital silhouette angiography,DSA)成功止血。内镜下止血总体成功率为98.7%(76/77)。内镜下止血治疗后有5例发生轻度并发症,无严重并发症,其中3例轻度胆管炎、2例轻症胰腺炎,并发症发生率为6.5%,均经静脉用药后成功治愈,无晚期相关并发症的发生。结论 ERCP术后出现十二指肠乳头切缘或周围出血经内镜下止血治疗是安全可行的,操作护士术中熟练的操作技巧、默契的医护配合,是此项治疗成功率和安全性的重要保证。
Abstract:
Objective To explore the nursing cooperation and skills of endoscopic treatment of hemorrhage after endoscopic retrograde cholangiopancreatography(ERCP).Methods Totally 77 patients who were suffered from pro-sphincterotomy hemorrhage after ERCP and treated with concurrent endoscopic hemostasis therapy in the endoscopy department from March 2011 to February 2021 were included in this study. Appropriate hemostasis method was selected according to the location and amount of bleeding.Through intraoperative precise medical cooperation and skilled nursing operation cooperation skills,the success rate and safety of endoscopic hemostasis treatment were analyzed.Results Endoscopic hemostasis was performed in all patients with duodenal papillary margin or peripheral bleeding after ERCP.Among them,76 cases were successfully hemostatic,1 case still had active bleeding after endoscopic hemostatic treatment,and was successfully hemostatic by digital silhouette angiography(DSA).The overall success rate of endoscopic hemostatic rate was 98.7%(76/77).After endoscopic hemostasis,5 cases had mild complications,including 3 cases of mild cholangitis and 2 cases of mild pancreatitis.The complication rate was 6.5%.They were successfully cured after intravenous medication,and there were no late related complications.Conclusions Endoscopic treatment of pro-endoscopic sphincterotomy hemorrhage is safe and feasible,and expected to become one of the preferred methods of the treatment.The skilled operation technique and tacit medical cooperation of operating nurses can significantly improve the success rate and safety of treatment.

参考文献/References:

[1] 中华医学会消化内镜学分会ERCP学组,中国医师协会消化医师分会胆胰学组,国家消化系统疾病临床医学研究中心.中国ERCP指南(2018版)[J].中华内科杂志,2018,57(11):772-801.
[2] RUSTAGI T,JAMIDAR P A.Endoscopic retrograde cholangiopan creatography-related adverse events:general overview[J].Gastrointest Endosc Clin N Am,2015,25(1):97-106.
[3] 孙燕,王庆.内镜下乳头肌切开术后迟发性胆道出血的治疗观察[J].中国中西医结合外科杂志,2016,22(3):279-281.
[4] 张燕霞,黄茜,马久红.急诊内镜下治疗内镜下逆行胰胆管造影术后十二指肠乳头出血27 例临床分析[J].中国内镜杂志,2016,2:83-86.

备注/Memo

备注/Memo:
【 收稿日期 】 2021-09-26 【 修回日期 】 2021-12-15
【 基金项目 】 上海市2016年度“科技创新行动计划”医学领域项目(16411951700)
【 作者简介 】 王淑萍,本科,副主任护师,从事内镜护理工作
【 通信作者 】 叶志霞,电话:021-81875091
更新日期/Last Update: 2022-01-15