彩超引导下PTCD治疗恶性梗阻性黄疸临床应用与分析  

Clinical Application and Analysis of Ultrasound- Guided PTCD in the Treatment of Malignant Obstructive Jaundice

作　　者：张国辉[1] 程艳[1] 李娟[1] 陈玲[1] 岳冬美 伍玉萍[1] 

机构地区：[1]大理学院曲靖教学医院,云南曲靖655000

出　　处：《大理学院学报（综合版）》2014年第2期52-54,共3页Journal of Dali University

摘　　要：目的：探讨彩超引导下经皮经肝穿刺胆管引流术治疗恶性梗阻性黄疸的临床意义。方法：分析经皮肝穿刺胆道引流术治疗43／51例恶性阻塞性黄疸患者的成功率与并发症，其中胆管癌24例，胰头癌22例，壶腹癌4例，手术后胆管狭窄1例。结果：47例穿刺成功（47／51，92．15％），其中经肝左叶肝内胆管置管40例，经肝右叶肝内胆管置管4例，肝左叶及肝右叶肝内胆管均置管3例。4例穿刺失败均为因肝内胆管内径纤细无法成功置入引流管；穿刺术后随访1周～12个月，1例胆管感染，1例随访3月死亡，其余病例均引流通畅，先明显并发症。结论：彩色多普勒超声引导下经皮肝穿刺胆道引流术治疗恶性阻塞性黄疸操作简便，安全、有效。Objective： To explore the clinical significance of ultrasound-guided percutaneous transhepatic cholangiography and drainage （PTCD） in the treatment of malignant obstructive jaundice.Methods： The success rate and complications of 51 patients with obstructive jaundice （24 cases of cholangiocarcinoma, 22 cases of pancreatic cancer, 4 cases of ampullary carcinoma, 1 case of postoperative biliary stricture） were examined.Results： Forty-seven cases were successfully operated （47/51, success rate 92.15%）, 40 cases of intrahepatic bile duct catheter were from left hepatic lobe, 4 cases were from right lobe and 3 cases of intrahepatic bile duct catheter were in left or right hepatic lobe. There were 4 cases failed due to the small inner diameter of intrahepatic bile ducts. In followed up for 1 week to 12 months, 1 case were biliary infection, I case died in 3 month, the remaining cases were found unobstructed drainage and no obvious complications.Conclusion： Color Doppler ultrasound-guided PTCD was simple, safe and effective in the treatment of malignant obstructive jaundice.

关 键 词：彩超 恶性梗阻性黄疸 经皮肝穿刺胆道引流术 

分 类 号：R657.43[医药卫生—外科学]