护理查房—肝门胆管.ppt

11-17生化报告： 肝功能：总胆红素80.3umol/L 明显升高（黄疸） 碱性硫酸酶 536U/L 显著升高（胆汁淤积） 谷氨酰转移酶931U/L升高 （胆汁排泄受阻） 11-18 免疫报告：糖类抗原50500IU/ml 糖类抗原199 443.5U/ml 癌胚抗原 11.16ng/ml 血清铁蛋白 1024ng/ml 均升高 血常规：中性粒细胞比率75.5 升高 出凝血功能：凝血酶原时间11.3s 11-19号患者头痛症状已明显好转，目前病情以肝功能异常为主，请消化内科会诊后转入我科继续治疗。 转入诊断：肝内胆管癌、梗阻性黄疸、 肝功能异常、双肾结石 转入消化科查体： 患者有恶心呕吐不适，无明显腹痛，胃纳差，不思饮食，无畏寒发热。神志清，皮肤巩膜黄染，心肺听诊未及明显异常，腹软。 在我科予以保肝、抑酸、营养治疗。 手术治疗： 24号下午：行ERCP +胆道扩张术+胆道支架置入术 镜下所见：于十二指肠部内部找见主乳头，乳头呈乳头型，开口处粘膜结节状增生，插入十二指肠乳头切开刀，循切开刀置入导丝至右肝管，注入30%泛影葡胺。X片示肝门部胆管狭窄，直径0.2cm，狭窄长度约4cm，右肝管扩张，最大直径约1cm，右侧肝内胆管扩张。循导丝予8.5Fr扩张探条扩张狭窄部位胆管，循导丝置入COOK公司TTSO-8.5Fr-15cm塑料支架一根，有胆汁引出。 + * Summary Heading. Text. Heading. Text. Heading. Text. Heading. Text. Use this space for overall reminders or special tips linked to the slide or occasion. Simply select this text and replace it with your own reminders. Click to edit title style ThemeGallery is a Design Digital Content Contents mall developed by Guild Design Inc. Description of the contents Description of the contents Description of the contents Description of the contents Title Title Title Title Click to edit title style CEO Sub Department Sub Department Sub Department Sub 01 Department Sub 01 Department Sub Department Sub 02 Department Sub 02 Department Sub 03 Department Sub 03 Department Department Click to edit title style Title in here Title in here Title in here Title in here Description of the company’s products Description of the company’s business Description of the company’s technology Description of the company’s contents Description of the company’s products Description of the company’s business Description of the company’s technology Description of the company’s contents ThemeGallery is a Design Digital Content Contents mall developed by Guild Design Inc. ThemeGallery is a Design Digital Content Contents mall developed by Guild Design Inc. Text in here Text in here Text in here Text in here Text in here Description of the c