Evidence-based nursing care on prevention of post-pancreaticoduodenectomy hemorrhage_West China Medical Journal

Authors：

HU Yanjie , QIN Li , WANG Yao ,  LUO Yanli

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LUO Yanli, Email: luoyl6@126.com

Keywords：

Evidence-based nursing; Pancreaticoduodenectomy; Gastrointestinal hemorrhage

DOI：

10.7507/1002-0179.201603275

Video：

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Objective To explore how to integrate the various sources of information in designing an evidence-based nursing care plan for preventing gastrointestinal hemorrhage (GIH) after pancreaticoduodenectomy (PD). Method Papers and references about prevention of GIH after PD were searched between September and October 2015, and an evidence-based nursing care plan was drawn up and implemented from November 2015 to January 2016. Results A total of 79 papers were found and of which 17 were aviliable. Thirty-nine patients were cared on the basis of the effective project, of whom one was dignosed with GIH on the 3rd postoperative day and the rate of post-PD hemorrhage was 2.6%. All patients were diacharged on the 6th or 7th postoperative day. Conclusion Exploring evidences under the guidance of scientific method and applying them to clinical nursing can prevent post-PD hemorrhage and improve life quality of patients.

Citation： HU Yanjie, QIN Li, WANG Yao, LUO Yanli. Evidence-based nursing care on prevention of post-pancreaticoduodenectomy hemorrhage. West China Medical Journal, 2018, 33(5): 579-583. doi: 10.7507/1002-0179.201603275 Copy

1.	Sredl D, Aukamp V. Evidence-based nursing care management for the pregnant woman with anostomy. J Wound Ostomy Continence Nurs, 2006, 33(1): 42-49.
2.	Blanc T, Cortes A, Goere D, et al. Hemorrhage after pancreaticoduodenectomy: when is surgery still indicated?. Am J Surg, 2007, 194(1): 3-9.
3.	胡雁. 循證護理學. 北京: 人民衛生出版社, 2012: 12-105.
4.	李麗, 楊立群, 王健, 等. 惡性梗阻性黃疸患者圍手術期凝血功能變化規律分析. 第二軍醫大學學報, 2004, 10(10): 1139-1140.
5.	孫葉飛, 李華. 38 例胰十二指腸切除術圍手術期護理體會. 中國醫科大學學報, 2014, 43(1): 87-89.
6.	Xia X, Huang C, Cen G, et al. Preoperative diabetes as a protective factor for pancreatic fistula after pancreaticoduodenectomy: a meta-analysis. Hepatobiliary Pancreat Dis Int, 2015, 14(2): 132-138.
7.	Malleo G, Mazzarella F, Malpaga A, et al. Diabetes mellitus does not impact on clinically relevant pancreatic fistula after partial pancreatic resection for ductal adenocarcinoma. Surgery, 2013, 153(5): 641-650.
8.	鄭芹, 盧彩霞, 葉志霞. 循證護理在預防胰十二指腸切除術后早期并發癥中的應用. 中華護理雜志, 2007, 42(12): 1129-1131.
9.	Papadopoulos V, Filippou D, Manolis E, et al. Haemostasis impairment in patients with obstructive jaundice. J Gastrointestin Liver Dis, 2007, 16(2): 177-186.
10.	李良. 梗阻性黃疸患者胰十二指腸切除術后圍手術期凝血功能的變化與并發癥的關系. 南京: 南京大學, 2010.
11.	張太平, 王天笑, 趙玉沛. 胰腺癌診斷和治療的瓶頸與對策. 中華消化外科雜志, 2012, 11(1): 41-44.
12.	Sohn TA, Yeo CJ, Cameron JL, et al. Do preoperative biliary stents increase postpancreaticoduodenectomy complications?. J Gastrointest Surg, 2000, 4(3): 258-267.
13.	陳道瑾, 成偉. 胰十二指腸切除術的出血和止血. 世界華人消化雜志, 2009, 17(5): 482-484.
14.	Zhu XH, Wu YF, Qiu YD, et al. Effect of early enteral combined with parenteral nutrition in patients undergoingpancreaticoduodenectomy.World J Gastroenterol, 2013,19(35): 588-5896.
15.	Rosenberg D, Eichorn A, Alarcon M, et al. External validation of the risk assessment model of the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) for medical patients in a tertiary health system, J Am Heart Assoc, 2014,3(6): e001152.
16.	Distler M, Rückert F, Hunger M, et al. Evaluation of survival in patients after pancreatic head resection for ductal adenocarcinoma. BMC Surg, 2013, 13: 12.
17.	王春田. 胰十二指腸切除術后預防性引流管拔管策略與術后并發癥關系的研究. 長春: 吉林大學, 2014.
18.	Wellner UF, Kulemann B, Lapshyn H, et al. Postpancreatectomy hemorrhage--incidence, treatment, and risk factors in over 1,000 pancreatic resections. J Gastrointest Surg, 2014,18(3): 464-475.
19.	Beyer L, Bonmardion R, Marciano S, et al. Results of non-operative therapy for delayed hemorrhage after pancreaticoduodenectomy. J Gastrointest Surg, 2009, 13(5):922-928.

1. Sredl D, Aukamp V. Evidence-based nursing care management for the pregnant woman with anostomy. J Wound Ostomy Continence Nurs, 2006, 33(1): 42-49.
2. Blanc T, Cortes A, Goere D, et al. Hemorrhage after pancreaticoduodenectomy: when is surgery still indicated?. Am J Surg, 2007, 194(1): 3-9.
3. 胡雁. 循證護理學. 北京: 人民衛生出版社, 2012: 12-105.
4. 李麗, 楊立群, 王健, 等. 惡性梗阻性黃疸患者圍手術期凝血功能變化規律分析. 第二軍醫大學學報, 2004, 10(10): 1139-1140.
5. 孫葉飛, 李華. 38 例胰十二指腸切除術圍手術期護理體會. 中國醫科大學學報, 2014, 43(1): 87-89.
6. Xia X, Huang C, Cen G, et al. Preoperative diabetes as a protective factor for pancreatic fistula after pancreaticoduodenectomy: a meta-analysis. Hepatobiliary Pancreat Dis Int, 2015, 14(2): 132-138.
7. Malleo G, Mazzarella F, Malpaga A, et al. Diabetes mellitus does not impact on clinically relevant pancreatic fistula after partial pancreatic resection for ductal adenocarcinoma. Surgery, 2013, 153(5): 641-650.
8. 鄭芹, 盧彩霞, 葉志霞. 循證護理在預防胰十二指腸切除術后早期并發癥中的應用. 中華護理雜志, 2007, 42(12): 1129-1131.
9. Papadopoulos V, Filippou D, Manolis E, et al. Haemostasis impairment in patients with obstructive jaundice. J Gastrointestin Liver Dis, 2007, 16(2): 177-186.
10. 李良. 梗阻性黃疸患者胰十二指腸切除術后圍手術期凝血功能的變化與并發癥的關系. 南京: 南京大學, 2010.
11. 張太平, 王天笑, 趙玉沛. 胰腺癌診斷和治療的瓶頸與對策. 中華消化外科雜志, 2012, 11(1): 41-44.
12. Sohn TA, Yeo CJ, Cameron JL, et al. Do preoperative biliary stents increase postpancreaticoduodenectomy complications?. J Gastrointest Surg, 2000, 4(3): 258-267.
13. 陳道瑾, 成偉. 胰十二指腸切除術的出血和止血. 世界華人消化雜志, 2009, 17(5): 482-484.
14. Zhu XH, Wu YF, Qiu YD, et al. Effect of early enteral combined with parenteral nutrition in patients undergoingpancreaticoduodenectomy.World J Gastroenterol, 2013,19(35): 588-5896.
15. Rosenberg D, Eichorn A, Alarcon M, et al. External validation of the risk assessment model of the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) for medical patients in a tertiary health system, J Am Heart Assoc, 2014,3(6): e001152.
16. Distler M, Rückert F, Hunger M, et al. Evaluation of survival in patients after pancreatic head resection for ductal adenocarcinoma. BMC Surg, 2013, 13: 12.
17. 王春田. 胰十二指腸切除術后預防性引流管拔管策略與術后并發癥關系的研究. 長春: 吉林大學, 2014.
18. Wellner UF, Kulemann B, Lapshyn H, et al. Postpancreatectomy hemorrhage--incidence, treatment, and risk factors in over 1,000 pancreatic resections. J Gastrointest Surg, 2014,18(3): 464-475.
19. Beyer L, Bonmardion R, Marciano S, et al. Results of non-operative therapy for delayed hemorrhage after pancreaticoduodenectomy. J Gastrointest Surg, 2009, 13(5):922-928.

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