C臂CT在经皮经肝胆道引流术治疗梗阻性黄疸中的应用  

The application of C-arm CT in performing PTCD for obstructive jaundice

作　　者：郑琳[1,2] 郭晨阳[1,2] 黎海亮[1,2] 余朴[1,2] 李亚楠[1,2] 

机构地区：[1]河南省肿瘤医院 [2]郑州大学附属肿瘤医院放射介入科,450008

出　　处：《介入放射学杂志》2013年第12期1007-1010,共4页Journal of Interventional Radiology

摘　　要：目的探讨C臂CT在经皮经肝胆道引流术(PTCD)治疗梗阻性黄疸中的应用。方法回顾性分析82例梗阻性黄疸患者,A组43例在C臂CT引导下PTCD治疗,B组39例在X线透视引导下PTCD治疗。研究终点是穿刺成功(自穿刺开始至安全地将导丝置入合适的胆管内)。观察指标是穿刺次数、穿刺透视时间、总穿刺时间、辐射暴露剂量及并发症(胆道出血、胆汁性腹膜炎)的发生率。结果 A组平均每例穿刺(1.1±0.3)次,显著少于B组的(2.8±0.6)次。A组穿刺透视时间为(13.1±2.7)s,穿刺时间为(46.9±9.7)s,均显著短于B组(33.7±6.2)s及(90.7±17.2)s。A组辐射暴露剂量(2.61±0.53)mGy也低于B组(6.75±1.23)mGy。B组有6例出现胆道出血。结论在PTCD治疗中,由C臂CT引导穿刺胆管较常规透视引导所需穿刺次数及时间更少。Objective To discuss the clinical application of C-arm CT in performing percutaneous transhepatic cholangiopancreatic drainage （PTCD） for obstructive jaundice.Methods The clinical data of 82 patients with obstructive jaundice were retrospectively analyzed.The patients were divided into study group （n =43） and control group （n =39）.C-arm CT guided PTCD was performed for patients of the study group,while under fluoroscopic guidance PTCD was carried out for patients of the control group.The end point of the study was the successful puncture,i.e.a safe procedure course from the correct puncturing to the safe placement of a guide-wire into a proper bile duct.The times of puncturing,the fluoroscopy time for the procedure,the total puncturing time,the exposure radiation dose,and the occurrence of complications such as hemobilia,biliary peritonitis,etc.were recorded.The results were analyzed.Results The number of puncturing in the study group was （1.1 ± 0.3） times,while it was （2.8 ± 0.6） times in the control group,the difference between the two groups was significant.The fluoroscopy time and the total puncturing time of the study group were （13.1 ± 2.7） sec and （46.9 ± 9.7） sec respectively,while those of the control group were （33.7 ± 6.2） see and （90.7 ± 17.2） sec respectively.The fluoroscopy time and the total puncturing time of the study group were much shorter than those of the control group.The exposure radiation dose of the study group was （2.61 ± 0.53）mGy,while the exposure radiation dose of the control group was （6.75 ± 1.23）mGy.The exposure radiation dose of the study group was lower than that of the control group.Hemobilia occurred in 6 patients of the control group.Conclusion In treating obstructive jaundice with PTCD,the use of C-arm CT can reduce the fluoroscopy time and the total puncturing times.

关 键 词：梗阻性黄疸 C臂CT 穿刺 经皮经肝胆道置管引流 介入性 

分 类 号：R735.7[医药卫生—肿瘤]