PTBD治疗肝内胆管微扩张型梗阻性黄疸  

The use of PTBD in patients with obstructive jaundice with nondilated intrahepatic bile ducts

作　　者：赵之明[1] 于德江[2] 纪文斌[1] 段卫东[1] 陆宏伟[1] 叶晟[1] 李海林[1] 

机构地区：[1]解放军总医院肝胆外科,北京100853 [2]解放军总医院超声科,北京100853

出　　处：《中国临床实用医学》2010年第1期33-35,共3页China Clinical Practical Medicine

摘　　要：目的探讨超声实时引导结合X线透视下，经皮肝胆管穿刺置管引流术（PTBD）治疗肝内胆管微扩张型梗阻性黄疸的操作技术及其临床应用价值。方法回顾性分析9例肝内胆管微扩张型梗阻性黄疸患者的临床资料，6例行右肝胆管PTBD，3例行左肝胆管PTBD。结果胆管穿刺置管成功率100％，术后短暂性发热1例、一过性血性胆汁1例，未出现腹腔出血及胆汁性腹膜炎等严重并发症，术后一周胆红素平均下降（75．4±29．6）μmol／L。引流时间10d～5个月。结论超声引导结合X线透视下PTBD治疗肝内胆管微扩张型梗阻性黄疸是安全可行的。Objective To investigate the technical and clinical value of PTBD in patients with obstructive jaundice with nondilated intrahepatic bile ducts by the guiding of ultrasound combined with X-ray scan. Methods PTBD was performed in 9 patients with with nondilated intrahepatic bile ducts, guided by combining ultrasound and X-ray scan. 6 patients were punctured to right bile ducts and 3 were left bile ducts. Results Technical success was obtained in all patients. There were only two minor complications ： transient hemobilia （ n = 1 ） and fever（ n = 1 ）. No hemorrhage and biliary peritonitis were found after procedures. The bilirubin was reduced by75.4 ± 29. 6ummol/L one week later. Conclusion Ultrasound-and-fluoroscopy guided PTBD in patients with nondilated bile ducts is a safe, feasible, and efficient procedure for the palliation of biliary obstruction.

关 键 词：超声 X线透视 梗阻性黄疸 经皮肝胆管穿刺置管引流术(PTBD) 

分 类 号：R575[医药卫生—消化系统] R657.42[医药卫生—内科学]