鼻胆管Chapter 2 Nasobiliary drainage tube
学习目标
1.了解鼻胆管的留置时间
2.掌握留置鼻胆管期间的饮食及如何冲管
3.掌握以下词汇
obstructive jaundice 梗阻性黄疸
endoscopic retrograde cholangiopancreatography （ERCP） 逆行性胰胆管造影
nasal mucosa 鼻黏膜
intact 完好无损的
blood routine examination 血常规检查
blood amylase 血淀粉酶
Li Ming is a patient with benign obstructive jaundice.On the second day after endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic nasobiliary drainage (ENBD), Nurse Xiao Ran is providing nose and mouth care for him.
Xiao Ran: Li Ming, mouth care is done, and your nasal mucosa is intact.I just dripped compound mint oil to alleviate your nasal discomfort.
Li Ming: Thank you, Xiao Ran.For how many days will this tube stay in my body?
Xiao Ran: Usually three to five days.When your body temperature, blood routine examination results and blood amylase level are normal, there is no abdominal pain or bloating and the cholangiography results are normal, the tube will be removed.
Xiao Ran: Oh, you may eat some porridge today.Eat small but frequent meal.After eating, rinse your mouth to keep it clean.
Li Ming: Really? Is my blood amylase back to normal? Xiao Ran, may I ask you a question?
Xiao Ran: Ofcourse.
Li Ming: If it gets blocked, do I have to undergo ERCP again?
Xiao Ran: Not always.Usually, we use a 20 mL syringe for low pressure suction.Then rinse with gentamicin in 0.9% sodium chloride solution at low pressure.If the drainage is not effective,we will consider replacing the tube.
译文
李明是一位良性胆管梗阻性黄疸的患者，ERCP+ENBD术后第2天，小冉护士正在为他做鼻腔和口腔护理。
小冉：李明，口腔护理已经做好，鼻腔黏膜完好，刚刚滴了复方薄荷油，以减轻鼻腔的不适感。
李明：谢谢你，小冉，这个管子要留几天啊？
小冉：一般3～5天。体温、血常规、血淀粉酶正常，无腹痛、腹胀，胆管造影结果正常就可以拔管了。
小冉：你今天可以喝点粥了，少食多餐，进食后及时漱口保持口腔清洁。
李明：真的吗？我的血淀粉酶恢复正常了？小冉，我可以问一个问题吗？
小冉：当然。
李明：如果阻塞，我是否需要再次接受ERCP手术？
小冉：不一定，通常我们会用20 mL注射器先低压抽取，再用0.9%生理盐水+庆大霉素低压冲洗，如果还是引流不畅，才会进一步考虑重新置管。