付高洁　姜　波　张红梅　陶英歌牡丹江医学院第二附属医院消化内科，黑龙江牡丹江　157000

综合护理模式对肝胆管结石肝切除术后双套管冲洗引流的影响

付高洁姜波张红梅陶英歌▲
牡丹江医学院第二附属医院消化内科，黑龙江牡丹江157000

目的探讨综合护理模式对肝胆管结石肝切除术后双套管冲洗引流的影响。方法选择我院收治的肝胆管结石的患者有96例，分别采用综合护理（观察组）和常规护理（对照组），比较两组患者的临床各项指标、治疗效果以及不良反应情况。结果观察组的手术时间、术中输液量、术中出血量、住院时间等临床指标显著优于对照组（t=7.563、7.257、7.896、8.763，P＜0.05）；观察组患者治疗有效率为100.00%，对照组患者治疗有效率为81.25%，两组差异有统计学意义（χ2=9.931，P=0.003）；对照组患者术后不良反应率为12.50%，观察组患者术后不良反应率为2.08%，两组差异有统计学意义（χ2=7.680，P=0.010）。结论临床上应用综合护理模式对肝胆管结石肝切除术后双套管冲洗引流护理效果显著，可有效减少患者痛苦，缩短康复时间，降低手术创伤以及术后不良反应的发生情况。

综合护理；双套管冲洗；肝切除术；肝胆管结石

［Abstract］Objective To discuss the influence of comprehensive nursing on double-catheter washing drainage after hepatic calculus hepatectomy.M ethods 96 patients with hepatic calculus treated in our hospital were selected and were given either comprehensive nursing（observation group）or routine nursing（control group）.The clinical parameters，treatment effects，and side effects were compared between two groups.Results Clinical parameters including operation tine，infusion volume during operation，blood loss during operation，and hospital stay were all better in the observation group than in the control group（t=7.563，7.257，7.896，8.763，P＜0.05）.The response rate in the observation group was 100.00%，while in the control group was 81.25%，with significant difference（χ2=9.931，P=0.003）.The incidence rate of adverse reactionswas 12.50%in the control group and was 2.08%in the observation group，with significant difference （χ2=7.680，P=0.010）.Conclusion Comprehensive nursing has significant effect on double-catheter washing drainage after hepatic calculus hepatectomy，which can effectively reduce the pain of patients，shorten the recovery time，and reduce operative wound and incidence of postoperative adverse reactions.

［Key words］Comprehensive nursing；Double-catheterwashing；Hepatectomy；Hepatic calculus

肝胆管结石一般是指发生于胆管系统内部的结石，常伴有一定量的胆红素钙结石混合存在，肝胆结石主要形成的原因有胆管寄生虫、胆管感染以及胆汁瘀滞［1］。常见的临床表现是腹部剧痛，一般治疗的原则为清除病灶、解除梗阻、通畅引流［2］。相关资料表示［3］：肝胆管结石常伴有肝胆管狭窄。临床常规应用肝胆管结石肝切除术治疗，其是一种有效的手术方式，且临床效果良好。……