PTCD管Chapter 8 Percutaneous transhepatic chola...
学习目标
1.熟悉PTCD作用
2.掌握PTCD置管期间体位与活动
3.掌握饮食指导
4.了解导管的护理
5.掌握以下词汇
X-ray fluoroscopy X线引导下
B-ultrasound guidance B超引导下
supine position 仰卧位
diarrhea 腹泻
Li Ming suffers from malignant obstructive jaundice and has undergone percutaneous transhepatic cholangial drainage(PTCD).Xiao Ran is his primary nurse.PTCD is a technique for percutaneous transhepatic puncture of bile ducts and placement of drainage tubes under the guidance of imaging equipment (usually X-ray fluoroscopy or B-ultrasound guidance) to drain bile out of the body or into duodenum.The patient's jaundice is obviously alleviated.Abdominal bloating is relieved and liver function is improved.He has increased appetite and improved mood.
Xiao Ran: Hi Li Ming, how are you feeling now?
Li Ming: Not too bad.But I do not dare to move.
Xiao Ran: Take it easy.Maintain supine position in the initial 6 hours after surgery.The drainage bag should be lower than the puncture site when you get out ofbed, and it should be lower than the midaxillary line when you lie down.
Li Ming: Thank you.Can I drink water now?
Xiao Ran: You should fast in the first 8 hours after operation.Then choose low fat diet with sufficient calorie, protein, and vitamin.Eat small but frequent meals of digestible food.You may gradually transition to regular diet if there is no abdominal bloating, diarrhea, or other discomfort.Be sure to avoid high fat diet.
Li Ming: Is there anything else I should pay attention to?
Xiao Ran: First, the catheter should be fixed properly and kept unblocked.Reversal and distortion should be avoided.Second, observe the color, nature and quantity of the drainage liquid.Finally, seek help from your doctor whenever you do not feel good.
Li Ming: Thank you very much.
译文
李明患有恶性梗阻性黄疸、已接受了经皮肝穿刺胆道引流术（PTCD），小冉是他的责任护士。PTCD是在影像设备（通常为X线透视下或B超引导下）引导下经皮经肝穿刺胆管并置入引流管，使胆汁流向体外或十二指肠的技术。患者黄疸明显减退，腹胀缓解，肝功能改善，食欲提高，心情也好多了。
小冉：你好，李明，现在感觉怎么样？
李明：还好，我现在不敢活动。
小冉：别紧张，术后6小时保持平卧，如果要下床活动，引流袋要低于穿刺部位，平卧时要低于腋中线。
李明：谢谢，我现在能喝水吗？
小冉：术后8小时禁食、禁水，饮食以低脂、高热量、高蛋白质、高维生素、易消化、少食多餐为原则，如无腹胀、腹泻等不适主诉，逐渐过渡到普食，忌高脂饮食。
李明：我还有其他需要注意的吗？
小冉：首先，导管要固定好，保持通畅，避免反折、扭曲；其次，观察引流液的颜色、性质和量；最后，如果有其他不适症状，及时告知医生。
李明：非常感谢！