Endoskopik Retrograd Kolanjiopankreatografi Uygulamalarında Klinik Süreç ve Hemşirelik Yönetimi

Öz

Endoskopik retrograd kolanjiyopankreatografi (ERCP), safra yolu ve pankreas hastalıklarının yan görüşlü endoskopi ve floroskopi kullanılarak tanı/tedavisinde kullanılan endoskopik bir tekniktir. %5-10 morbidite ve %0,1-1 mortalite oranıyla ERCP, teknik olarak zorlu işlemlerden biri olarak kabul edilir. ERCP sonrası pankreatit, işlemle ilişkili en sık görülen komplikasyon olarak kabul edilir ve görülme sıklığı %3,5 ile %9,7 arasında değişir. ERCP sonrası pankreatitten daha az sıklıkta görülen diğer komplikasyonlar arasında kolanjit, kanama, perforasyon, hipoksemi ve kolesistit yer alır. Bu istenmeyen olayların erken saptanması ve komplikasyon riskinin en aza indirilmesinde işlem öncesi dikkatli hazırlık, işlem sırasında takip ve işlem sonrası hemşirelik bakımı büyük önem taşımaktadır. ERCP işlemi hekim, hemşire ve anestezi ekibinin işbirliğini gerektiren multidisipliner bir yaklaşıma dayanmaktadır. Hemşireler, ERCP öncesinde hasta ve ailesini eğitmek, laboratuar ve radyolojik testleri takip etmek ve üniteyi hazırlamak; işlem sırasında hastayı izlemek, pozisyonlandırmak ve hekimle koordinasyonu sağlamak; işlem sonrasında hastanın vital bulgularını ve komplikasyonlarını yakından izlemek ve taburculuk eğitimi vermekten sorumludur. Bu derlemenin amacı, literatür taramasına dayanarak, endoskopik retrograd kolanjiyopankreatografinin tüm süreçlerinde hemşirenin rolüne ilişkin güncel yaklaşımları ele almaktır. Literatürden elde edilen bulgular komplikasyonların önlenmesi ve tedavinin başarısı için hasta eğitimi, ekip çalışması ve hasta takibinin kritik öneme sahip olduğu vurgulanmaktadır.

Anahtar Kelimeler

• Endoskopik retrograd kolanjiyopankreatografi
• Hemşirelik
• Hasta bakımı

Clinical Process and Nursing Management in Endoscopic Retrograde Cholangiopancreatography Procedures

Öz

Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic technique used in the diagnosis/treatment of bile duct and pancreatic diseases using side-view endoscopy and fluoroscopy.  With a morbidity rate of 5-10% and a mortality rate of 0.1-1%, ERCP is considered one of the most technically challenging procedures. Post-ERCP pancreatitis is considered the most common complication associated with the procedure, with an incidence ranging from 3.5% to 9.7%. Other complications, which are less frequent than post-ERCP pancreatitis, include cholangitis, bleeding, perforation, hypoxemia, and cholecystitis. Careful preparation before the procedure, monitoring during the procedure, and nursing care after the procedure are of great importance in the early detection of these adverse events and in minimizing the risk of complications. The ERCP procedure is based on a multidisciplinary approach that requires the collaboration of the physician, nurse, and anesthesia team. Nurses are responsible for educating the patient and family before ERCP, tracking laboratory and radiological tests, and preparing the unit; for monitoring the patient during the procedure, positioning, and coordinating with the physician; and, after the procedure, for closely monitoring the patient’s vital signs and complications as well as providing discharge education. The aim of this review is to address current approaches to the nurse’s role throughout all processes of endoscopic retrograde cholangiopancreatography, based on a review of the literature. According to findings obtained from the literature, patient education, teamwork, and patient monitoring are emphasized as critical for the prevention of complications and the success of treatment.

Anahtar Kelimeler

• Endoscopic retrograde cholangiopancreatography
• Nursing
• Patient care

Kaynakça

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