摘要
目的:总结经皮经肝胆管硬镜联合腹腔镜、钬激光治疗肝内胆管结石的手术配合要点。方法:选取2019年9-12月经皮经肝胆管硬镜联合腹腔镜、钬激光治疗的肝内胆管结石患者13例,术前对患者进行耐心的健康教育,认真做好仪器准备、术中与医生默契配合、熟练操作贵重设备等。结果:12例患者手术顺利,取石成功,未出现与经皮经肝胆管硬镜治疗相关严重并发症。其中1例经多次鞘管进胆管硬镜,未能达到肝内胆管结石位置,于右侧穿刺口放置16 F尿管引流,结束手术。结论:术前给予患者优质心理护理,充分的术前准备、熟练掌握肝胆专科手术护理知识,巡回护士与器械护士娴熟的配合、手术医生精湛的操作技能、术中医护的协调配合是手术成功的关键。
Objective:To summarize the operative cooperation points of percutaneous transhepatic choledochoscopy combined with laparoscopy and holmium laser in the treatment of intrahepatic bile duct stones.Methods:From September to December 2019,13 cases with intrahepatic bile duct stones treated by percutaneous transhepatic choledochoscopy combined with laparoscopy and holmium laser were selected,before the operation,we carried out patient health education,carefully prepared the instruments,and during the operation,we cooperated with doctors and skillfully operated expensive equipment.Results:The operation was successful in 12 patients with successful stone extraction.No serious complications related to percutaneous transhepatic choledochoscopy were found.One of them failed to reach the position of intrahepatic bile duct stones after multiple times of intrahepatic cholangioscopy,a 16 F catheter was placed at the right puncture site for drainage,end the operation.Conclusion:The key to the success of the operation is to give the patients high quality psychological nursing before operation,to make full preparation before operation,to master the nursing knowledge of hepatobiliary surgery,to cooperate skillfully between itinerant nurses and instrument nurses,to operate skillfully by surgeons,and to coordinate and cooperate with doctors and nurses.
作者
李文姬
杨兵
谢丽洪
龚凤球
Li Wenji;Yang Bing;Xie Lihong;Gong Fengqiu(The First Affiliated Hospital of Zhongshan University,Guangdong Guangzhou 510080)
出处
《中国社区医师》
2020年第31期139-140,共2页
Chinese Community Doctors
关键词
胆管硬镜
腹腔镜
钬激光
肝内胆管结石
手术配合
Choledochoscopy
Laparoscopy
Holmium laser
Intrahepatic bile duct stones
Operation cooperation
