經皮穿肝膽道引流管(Percutaneous Transhepatic Cholangiography with Drainage, PTCD)常需長期引流並於出院後自我照顧。本專案係針對使用PTCD之個案，建立 一致性衛教標準及客觀的評值辦法，以提昇護理照顧品質並協助病患達到最佳自我照顧的護 理目標。本案依據持續品質改進過程，進行現況分析及確立問題，擬定可行之衛教方案，制 定PTCD衛教單張，PTCD護理照顧標準及PTCD之衛教成果評值表，並加以監測成效。本專案 係在臺北市某醫學中心胃腸科病房推行，自85年1月1日至86年12月31日，總計收案111 名，所收集資料以百分比、平均值作統計分析。結果顯示經過一致性的衛教後病患對PTCD 的知識方面，認知平均得分為92.5分較前測67.9分進步24.6分，居家照顧注意事項平均得 分為98分較前測64.5分進步33.8分;技能方面，傷口護理平均得分為86.4分較前測55.5 分進步30.9分，引流管護理，平均得分為94.1分較前測73.5分進步20.6分。由專案結果 顯示，有計畫的一致性的衛教能提高病患對PTCD的認識及自我照顧能力，除對臨床實務有極 大貢獻外，也加強護理人員衛生教育能力，並建立胃腸科PTCD之護理標準，進一步提昇專科 護理品質及發展。

　　　　　It's necessary to have long term self-care of the drainage for cases of percutaneous transhepatic cholangiography with drainage (PTCD). The purpose of this strategy is to set up a uniformly nursing care standard for cases of PTCD in order to promote the quality of nursing care and reach nursing goal of best self-care. The standard was set up according to improved knowledge and experience in PTCD care. An objective evaluation chart was used to evaluate and analyze the effect of the nursing care standard. From January 1996 to December. 1997, 111 hospitalized patients with PTCD were gathered and taught the uniform nursing care standards by nursing personnel in 4 gastrointestinal wards of VGH-Taipei. The results showed that knowledge and skill of PTCD care was improved very much and the complications of PTCD care became much less. In conclusion, the application of an uniform nursing care standard is effective in the promotion of the Nursing care quality in the cases of PTCD.