Nursing of PTCD with biliary stenting for malignant biliary obstruction: analysis of 34 cases

Objective To evaluate the care efficacy of percutaneous transhepatic biliary drainage(PTCD) combined with biliary stenting in patients with malignant obstructive jaundice,and to summarize the nursing experience in complications. Methods The nursing materials for 34 patients with malignant obstructive jaundice treated by PTCD combined with biliary stenting in our department between April,2008 and March,2014 were analyzed retrospectively. Results The surgery in all cases was successfully.The jaundice relieved exactly in 5 days in 6 cases;relieved exactly in 14 days in 18 cases;improved obviously in 14 days in 7 cases,among them,yellow skin and sclera,and skin pruritus faded away in 3 to 7 days,color of urination and defecation recovered in 2 to 5 days;elevated amylase level in blood and urine in 5 cases,recovered after somatostatin treatment of 4 to 7 days;localized biliary peritonitis in 4 cases,the symptoms disappeared after the replacement of PTCD catheter;accidental catheter detachment in 2 cases,coped timely;1 patient was discharged with a tube pinch.There was no perforation,peritonitis and other complications. Conclusions PTCD combined with biliary stenting for malignant obstructive jaundice was effective,with less invasive.The reasonable and effective perioperative nursing care can provide a good guarantee for the success of the procedure and patient prognosis.The systematic and personalized care programs as well as effective measures can provide important protection for stent implantation in patient recovery.