Analysis of Targeted Post-operative Nursing Outcome in 1246 Patients with Percutaneous Transhepatic Biliary Drainage

Abstract

Jaundice is a detection index in many disease conditions commonly characterized by yellowish staining of the skin and mucous membranes. This work studies the postoperative care outcome in 1,246 patients (669 males and 577 females) with obstructive jaundice who underwent percutaneous transhepatic biliary drainage (PTBD). These patients were admitted to the interventional vascular surgery department of our hospital from February 2017 to February 2022. From the results, frequent wound re-dressing and maintenance of the drainage tube had significant positive influence on wound healing and patient recovery. The data also showed strict adherence by patients to the doctor’s recommendation advising them to visit the interventional specialist care clinic in time for wound dressing change and drainage tube maintenance. As a result, there was no significant difference in wound allergy, exudation, redness and loosening among patients. A cross-sectional analysis of the effect of age on recovery revealed variations in the healing pattern (wound loosening and the redness) between patients of different ages although the relationship is not very clear due to the limited sample size. Efficient drainage tube maintenance promoted recovery and prevented the occurrence of related complications such as PTBD tube blockage and biliary tract infection. The establishment of the interventional specialist care clinic used in this study additionally ensures patients’ safety, and the incidence of complications have been reduced drastically. These achievements are attributable to the implementation of regular dressing change, drainage tube maintenance and health education for patients with PTBD tube. These practices have also improved on the level of specialty in nursing practice, increased the professional value of nurses and better recognition by the society.

Perceptions of transitional care services among patients with percutaneous transhepatic biliary drainage and multicentre health professionals: A qualitative study

“…In addition to the national government strengthening the creation of nurse talent teams and the provision of welfare protection from macro policies, medical institutions should also implement reasonable human resource allocation strategies. 32 It is critical that the nurses who provide care to patients have the best medical knowledge, 21 because their nursing behaviour and quality can affect patient outcomes. A national survey in the Netherlands found that nurses working in hospital gastrointestinal surgery had a low overall knowledge of PTBD placement procedures and catheter care, with half of the nurses reporting that their existing knowledge was insufficient.…”

“…It is suggested that healthcare professionals should pay more attention to the psychological state of PTBD patients, which is consistent with the findings of Mo Wei's study 20 . For patients with benign obstructive jaundice, PTBD can facilitate the rapid relief of jaundice and infection symptoms and provide a method for follow‐up treatment 21 . The relatively short time these patients had spent on the tube may have contributed to their positive attitude.…”

“…PTBD can successfully enable biliary decompression, but because it is an invasive intervention with potential complications, blockage, dislocation and cholangitis are often encountered in long‐term catheter therapy 25 . Standardized PTBD drainage tube care helps to reduce complications, ensure the effectiveness of interventional surgery and improve patients' quality of life 21 . Rattanakanlaya found that the quality of discharge guidance for PTBD patients was positively correlated with their discharge readiness, and a high degree of discharge readiness indicates that patients are ready for home care, have a better grasp of the knowledge of disease pipeline nursing and have a higher compliance and self‐care ability, which could effectively improve their quality of life outside the hospital 15 .…”

“…It is critical that the nurses who provide care to patients have the best medical knowledge, 21 because their nursing behaviour and quality can affect patient outcomes. A national survey in the Netherlands found that nurses working in hospital gastrointestinal surgery had a low overall knowledge of PTBD placement procedures and catheter care, with half of the nurses reporting that their existing knowledge was insufficient 33 .…”

“…20 For patients with benign obstructive jaundice, PTBD can facilitate the rapid relief of jaundice and infection symptoms and provide a method for follow‐up treatment. 21 The relatively short time these patients had spent on the tube may have contributed to their positive attitude. However, for patients with malignant obstructive jaundice, PTBD is a palliative treatment that can only relieve obstructive jaundice but has no effect on tumours invading bile ducts and thus cannot completely cure the disease.…”