Effect of care bundles on compliance to oral bile reinfusion in patients undergoing percutaneous transhepatic cholangial drainage and its clinical significantce

doi:10.3877/cma.j.issn.1674-0785.2022.08.014

Abstract

Abstract:

Objective

To analyze the application effects of care bundles in oral bile reinfusion (OBR) patients undergoing percutaneous transhepatic cholangial drainage (PTCD), and to evaluate its effect on compliance to OBR.

Methods

From January 2018 to December 2020, a total of 136 patients with obstructive jaundice underwent PTCD surgery at our department, 91 patients of whom were randomly divided into either a control group or an observation group after informed consent for OBR was obtained. Both groups received routine nursing care for hepatopancreatobiliary surgery, while the observation group additionally received care bundles. Liver function and nutritional status before curative operation were compared between the two groups. Compliance to OBR was also compared, and potential clinical significance was analyzed.

Results

In the observation group (n=46) and the control group (n=45), there were 44 (95.65%) and 34 cases (75.56%) who received comtinued OBR until curativel operation, respectively (χ²=7.50, P=0.006). The good compliance rate (32/46, 69.60%) in the observation group was significantly higher than that in the control group (21/45, 46.7%; χ²=4.90, P=0.027). There was no significant difference in liver function between the two groups before curative operation. However, nutritional status indicators of patients, such as serum albumin and peripheral blood lymphocyte count, were significantly better in the observation group than in the control group (35.32±4.10 vs 33.48±4.16, P=0.011; 2.54×10⁹/L ±0.85×10⁹/L vs 2.26×10⁹/L±0.66×10⁹/L, P=0.031).

Conclusion

Care bundles can effectively improve the rate of compliance to OBR in PTCD patients and the nutritional status of patients before curative operation.

Key words: Care bundles, PTCD, Oral bile reinfusion, Compliance, Obstructive jaundice

Na Zhao, Jian Feng, Yue Bian, Wenjie Bi, Jing Zhang, Chenglin Piao, Xin Lan, Qiang Li, Jianjun Leng. Effect of care bundles on compliance to oral bile reinfusion in patients undergoing percutaneous transhepatic cholangial drainage and its clinical significantce[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(08): 782-786.

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Figures/Tables 3

	干预组（n=46）	对照组（n=45）	t/χ²值	P值
年龄（岁， $x ¯$ ±s）	64.96±11.75	66.84±13.26	0.719	0.474
性别［例（%）］			0.09	0.766
男性	33（71.74）	31（68.89）
女性	13（28.26）	14（31.11）
原发病［例（%）］			0.30	0.960
肝门部胆管癌	9（50.0）	9（50.0）
胰腺癌	20（52.63）	18（47.37）
胆管下段或壶腹部肿瘤	14（51.85）	13（48.15）
其他	4（50.0）	4（50.0）
肝功能（ $x ¯$ ±s）
ALT（IU/L）	235.33±89.79	219.33±130.51	0.682	0.497
AST（IU/L）	192.76±75.87	172.29±119.04	0.980	0.330
GGT（IU/L）	235.48±233.44	313.03±277.23	1.445	0.152
ALP（IU/L）	271.39±232.57	300.67±219.88	0.617	0.539
TBIL（μmol/L）	300.71±104.19	268.30±89.10	1.593	0.115
DBIL（μmol/L）	214.51±83.97	186.49±67.94	1.747	0.084
电解质（ $x ¯$ ±s）
K⁺（mmol/L）	3.86±0.40	3.93±0.27	0.959	0.340
Na⁺（mmol/L）	138.20±38.51	141.04±38.60	0.352	0.725
营养状态（ $x ¯$ ±s）
ALB（g/L）	29.55±8.37	32.04±7.17	1.552	0.132
LYM（×10⁹/L）	2.22±0.89	2.46±1.14	1.113	0.269

	干预组（n=46）	对照组（n=45）	t/χ²值	P值
年龄（岁， $x ¯$ ±s）	64.96±11.75	66.84±13.26	0.719	0.474
性别［例（%）］			0.09	0.766
男性	33（71.74）	31（68.89）
女性	13（28.26）	14（31.11）
原发病［例（%）］			0.30	0.960
肝门部胆管癌	9（50.0）	9（50.0）
胰腺癌	20（52.63）	18（47.37）
胆管下段或壶腹部肿瘤	14（51.85）	13（48.15）
其他	4（50.0）	4（50.0）
肝功能（ $x ¯$ ±s）
ALT（IU/L）	235.33±89.79	219.33±130.51	0.682	0.497
AST（IU/L）	192.76±75.87	172.29±119.04	0.980	0.330
GGT（IU/L）	235.48±233.44	313.03±277.23	1.445	0.152
ALP（IU/L）	271.39±232.57	300.67±219.88	0.617	0.539
TBIL（μmol/L）	300.71±104.19	268.30±89.10	1.593	0.115
DBIL（μmol/L）	214.51±83.97	186.49±67.94	1.747	0.084
电解质（ $x ¯$ ±s）
K⁺（mmol/L）	3.86±0.40	3.93±0.27	0.959	0.340
Na⁺（mmol/L）	138.20±38.51	141.04±38.60	0.352	0.725
营养状态（ $x ¯$ ±s）
ALB（g/L）	29.55±8.37	32.04±7.17	1.552	0.132
LYM（×10⁹/L）	2.22±0.89	2.46±1.14	1.113	0.269

	干预组（n=46）	对照组（n=45）	χ²值	P值
依从性分层			8.54	0.014^a
良好	32	21
一般	12	13
差	2	11

	干预组（n=46）	对照组（n=45）	t值	P值
肝功能
ALT（IU/L）	93.35±72.34	111.31±63.23	1.26	0.211
AST（IU/L）	49.07±18.28	56.58±25.68	1.611	0.111
GGT（IU/L）	266.67±171.49	360.53±265.79	2.006	0.048^a
ALP（IU/L）	176.96±95.20	228.89±106.38	2.455	0.016^a
TBIL（μmol/L）	66.90±65.85	71.80±71.29	0.341	0.734
DBIL（μmol/L）	43.92±45.09	45.64±47.28	0.177	0.860
电解质
K⁺（mmol/L）	4.32±0.55	4.00±0.60	2.631	0.010^a
Na⁺（mmol/L）	135.59±2.73	136.42±3.17	1.347	0.181
营养状态
ALB（g/L）	36.35±3.95	34.29±3.27	2.696	0.008^a
LYM（×10⁹/L）	3.01±0.88	2.48±1.16	2.495	0.016^a

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