ABSTRACT
The establishment of a nutritional pathway is the premise and basis of nutritional therapy for patients with malignant tumor. The nasogastric tube, nasoenteric tube, and percutaneous endoscopic gastric/jejunostomy are commonly used clinical pathways for enteral nutrition (EN) therapy. However, these EN pathways are often difficult to establish in patients with malignant obstructive jaundice (MOJ) with pyloric or duodenum primary obstruction. For this reason, a new type biliary-intestinal nutrient tube placed through percutaneous transhepatic cholangiography drainage (PTCD) pathway was designed by the medical staff of hepatobiliary surgery department of Yinchuan First People's Hospital, and National Utility Model Patent of China were obtained (ZL 2020 2 0283951.5, ZL 2020 2 0288938.9). The new biliary-intestinal nutrient tube has two types: double-lumen tube and single-lumen tube, which consists of tube head, tube body, tail ring and developing ring. The double lumen tube realizes bile internal drainage and EN simultaneously through the double lumen structure of the tube body. The single-lumen tube is used for nutrient infusion after bile duct metal stent implantation, which is not limited by the type of nutrient solution. The tail ring of the two types of nutrient tube is placed in the upper jejunum to reduce retrograde infection and unexpected extubation. Compared with the prior art, the utility model has the advantages of simple structure, reasonable design, safe and effective placement through PTCD pathway, and opens up a new EN path for MOJ patients.
ABSTRACT
Objective To make a further recognition of the real quality of life of post-discharge patients who carry a percutaneous transhepatic biliary drainage (PTBD) tube due to malignant obstructive jaundice in order to formulate the corresponding scheme of health education and continued nursing. Methods By using qualitative research with phenomenological method, the interventional specialized nurse made a indepth interview with the post-discharge patients who carried a PTBD tube due to malignant obstructive jaundice. Colaizzi seven-step analysis method was adopted to collate and analyze the clinical data. Results A total of 10 patients were finally enrolled in this study. The main considerations of patients carrying a PTBD tube in daily life included the changes of self-care ability in daily life, intensification or absence of a patient's role; worrying about prolapse and infection of the tube; disordered self-image and social phobia; different degrees of physical discomfort and negative emotion with psychological pressure; hoping improvement of the drainage bag and fixed materials and way; hoping more convenient way of dressing, etc. Conclusion The post-discharge patients carrying a PTBD tube live in different levels of stress. The medical staff should carry out targeted health education and extension care to help them and make research to improve equipment, so as to improve self-care ability, reduce complications as well as psychological pressure, thus, to improve the quality of life.