Mi Na, Zhang Shuting, Zhu Zhili, Yu Yan, Li Wenjing, Zheng Lu, Chu Lingling, Li Jing
Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing, China.
Army Medical University, Chongqing, China.
Front Surg. 2022 Feb 23;9:791945. doi: 10.3389/fsurg.2022.791945. eCollection 2022.
We investigated the clinical efficacy of a modified nasobiliary fixation and drainage technique which was designed in an attempt to reduce unplanned extubation and tube blockage and improve bile drainage and the comfort of catheterized patients.
From January 2019 to December 2020, 230 patients receiving Endoscopic nasobiliary drainage (ENBD) during hospitalization were recruited to this study. Participants were randomly allocated to 2 groups by using the block randomization method: in the control group: the conventional method of nasobiliary fixation was adopted after surgery; in the test group: intraoperative annular cutting of nasobiliary tubes was performed and the exposed catheter length was standardized. The modified "tube-nose-ear" three-step technique was performed after surgery. The clinical efficacy of a modified nasobiliary fixation and drainage technique was evaluated and compared between the test group and the control group.
The rate of unplanned extubation and incidence of complications were significantly lower in the test group than the control group. In addition, the rate of bilirubin decrease after drainage was higher in the test group. Patient discomfort during catheterization was also significantly reduced using the modified technique ( < 0.05).
The modified technique of nasobiliary fixation and drainage technique can significantly reduce unplanned extubation and nasobiliary tube blockage after ENBD, facilitate biliary drainage, and improve patient comfort. This technique warrants wider application in clinical practice.
我们研究了一种改良的鼻胆管固定和引流技术的临床疗效，该技术旨在减少非计划拔管和导管堵塞，改善胆汁引流并提高置管患者的舒适度。
2019年1月至2020年12月，招募了230例住院期间接受内镜鼻胆管引流术（ENBD）的患者参与本研究。采用区组随机化方法将参与者随机分为2组：对照组：术后采用传统的鼻胆管固定方法；试验组：术中对鼻胆管进行环形切割并规范外露导管长度。术后采用改良的“管-鼻-耳”三步技术。对试验组和对照组改良鼻胆管固定和引流技术的临床疗效进行评估和比较。
试验组的非计划拔管率和并发症发生率显著低于对照组。此外，试验组引流后胆红素下降率更高。使用改良技术也显著降低了置管期间患者的不适感（P<0.05）。
改良的鼻胆管固定和引流技术可显著降低ENBD术后的非计划拔管和鼻胆管堵塞，促进胆汁引流，提高患者舒适度。该技术值得在临床实践中更广泛地应用。
