经皮肝胆道内、外引流术的临床应用  

The Clinical Application of Percutaneous Transhepatic BUiary Drainage

作　　者：赵忠春[1] 鲍俊杰 张曦彤[1] 徐克[1] 

机构地区：[1]中国医科大学附属第一医院放射科,110001 [2]内蒙古自治区赤峰市第二医院放射线科

出　　处：《介入放射学杂志》1997年第2期73-75,78,共4页Journal of Interventional Radiology

摘　　要：目的:总结39例应用经皮经肝胆道内、外引流术治疗良恶性阻塞性黄疸病例的经验,探讨其临床疗效及应用价值。材料与方法:39例均为不宜或不能外科治疗者。良性病变5例,恶性病变34例。均采取经皮经肝胆道穿刺,38例穿刺成功者再行阻塞段胆管开通术。28例获得开通,其中17例行金属内支架置入术(EMBE),2例行球囊导管扩张术,9例行多侧孔导管引流术。另10例未获开通者则仅行外引流治疗。结果:各引流方式均获较好疗效,但以 EMBE 治疗者最优,单纯外引流者较差。结论:(1)经皮经肝胆道内、外引流术创伤小,并发症少,易于操作,可适用于不宜外科治疗的良恶性阻塞性黄疸者。(2)几种引流方式可以互补,而应以 EMBE 作为最佳方法应用。Purpose:To summarize the experences of treating malignant obstructive jaun- dice by percutaneous transhepatic drainage of the bile duct,as well as discussing its clinical effect and practical value.Materials and Methods:Among the 39 patients who were all unsuitable for sur- gical operations,5 were benign,34 were malignant.All patients underwent percutaneous transhep- atic puncture of bile duct.38 cases who were successfully aspirated continued to undergone canal- ization of the obstructive parts 28 be finally successful.Among these patients,metallic stents were placed in 17 cases,balloon dilation in 2 cases,canalization with multi-side-hole catheter in 9 patients.Only external biliary drainage were performed in 10 patients.Results:All of there canal- ization method effected well in verious degrees,but the best result was obtained in the metallic stents group.Conclusion:(1)There is less injury and complication in percutaneous transhepatic drainage,either external or antegrade biliary drainage,and it ts also easy to operate,Interventional treatment is the first choice for patients who suffered from benign or malignant obstructive jaundice unahe undergone surgical operation(2)All the methods amend with each other,but the placement of metallic stent is the best one.

关 键 词：阻塞性黄疸 引流术 胆道内引流 胆道外引流 

分 类 号：R657.405[医药卫生—外科学]