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1、ERCP途径治疗高龄患者胆总管巨大结石的临床护理研究76湖南中医药大学JournalofTCMUniv.ofHunan2011年2月第31卷第2期Feb.2011v01.31No.29■护理医学ERCP途径治疗高龄崽者胆总管巨大结石的临床护理研究陈吾霞，陶海燕，金燕，孙源源(南通大学附属南通第三医院消化科，江苏南通226006)1摘要］目的探讨经内镜(ERCP途径)治疗高龄患者胆总管巨大结石的可行性和护理操作配合•方法40例高龄胆总管巨大结石患者完善术前准备，在密切监护下经十二指肠镜先行内镜下逆行胰胆管造影术(ERCP),发现胆总管结石后行内镜下十二指肠乳
2、头括约肌切开术(EST)和机械碎石术(EML)取石,视具体情况留置鼻胆管引流•结果38例取石成功，取石成功率95.0%,有11例行鼻胆管引流•乳头肌切12,创面轻度渗血4例,一过性高淀粉酶血症9例,未发生严重并发症和死亡•结论ERCP途径(ESTE<:合EML)治疗高龄患者胆总管巨大结石安全有效，娴熟的内镜操作技术，专科护士精心的术前准备，准确迅速的术中配合和监护,以及完善的术后护理是保证治疗成功的重要条件.(关键词］ERCP;胆总管巨大结石;高龄;内镜治疗护理［中图分类号］R473［文献标识码］B(文章编号］doi:10.39690issn.l67
3、4—070X.2011.02.028.076.04StudyonclinicalnursingofERcommonbileductstonesinCPtherapyoflargeelderlypatientsCHENWu—xia,TAOHai-yan,JINYan,SUNYuan-yuan(DepartmentofGastroenterology,NantongThirdHospitalAffiliatedNantongUniversity,Nantong226006,China)(Abstract)ObjectiveTostudythefeasibili
4、tyandeffectofendoscopictherapyoflargecommonbileductstonesinelderlypatients.Methods40elderlypatientswithlargecommonbileductstonesconsummatedpreoperotivepreparation,thenunderwentendoscopicretrogradecholangiopancreatography(ERCP)throughduodenoscopyinclosemonitoring.ALLpatiensweretrea
5、tedwithendoscopicsphincterotomy(EST)andendoscopicmechanicalhthotripsy(EML)aftercommonbileductstonesvisualization.Endoscopicnasobiliarydrainagewasgivenaccordingthespecificcircumstances.ResultsBilestonesof38caseswereobtained.thesuccessratewas95.0%.among11patientsforthetreatmentofend
6、oscopenasobiliarydrainage.Only4casessufferedstaxisofmildsphincterincisionand9casessufferedtransienthyperamylasemia.Noserouscomplicationanddeathwereabserved.ConclusionESTassociatedwithEMLaresafeandeffectiveinthetreatmentofcommonbileductstonesinelderlypatients.Skillfulendoscopicoper
7、ation,carefulpreoperotivepreparation,intraoperativeclosemonitoringandperfectpostoperativenursingarethekeysforthesuccessfuloperation.[Keywords)ERCP;largecommonbileductstone:eIderly:endoscopictherapy;nursing内镜下逆行胰胆管造影术(ERCP)广泛应用于胆胰疾病的诊断和治疗，是目前胆总管结石首选的微创治疗手段,但应用于高龄患者的安全性及有效性值得关注…•高龄患
8、者常合并多种慢性基础疾病，增加了治疗风险,而且在取石过程中，会遇到
