After percutaneous liver puncture biliary tract (PTC) angiography examination, what should be observed emphatically?

Stay in bed for 24 hours. Check blood pressure, pulse and breathing every hour until it is stable. Observe closely whether there is bleeding, infection and other signs, and ensure that the drainage tube is sterile, closed, unobstructed, properly fixed, record the nature and amount of drainage fluid, and pay attention to the protection of the skin around the drainage tube.

If the drainage fluid is viscous, the drainage tube and bile duct can be rinsed with normal saline every day to keep them unobstructed, and antibiotics can be injected. Generally, the drainage tube is placed for 1 to 14 days, and the second angiography review can confirm that the internal drainage is unobstructed.

Management of postoperative complications

Bile duct infection: Some patients with malignant obstruction have been complicated with bile duct infection before operation, and their resistance is low. Moreover, infection may be caused during operation, which can lead to bile duct infection. Therefore, aseptic operation should be strictly performed and antibiotics should be applied.

Treatment of hemorrhage: The causes of abdominal hemorrhage during PTCD are rupture of liver capsule, damage to large blood vessels and poor coagulation mechanism during puncture. General hemostasis methods can be effective, and angiography and embolization should be performed when necessary. Therefore, vitamin K1 should be injected intramuscular before operation, fine needle aspiration should be used as far as possible during operation, and hemostatic drugs should be continued for 3 days after operation.

Others: (1) Bile leakage: avoid piercing the bile duct wall, pay attention to gentle operation; (2) Stent and drainage tube displacement: the length and placement position of the stent should be correctly selected.

Dietary care: fasting for 2 hours after operation, and giving patients a diet of low fat, high protein, high carbohydrate and rich vitamins

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