DSA下行PTCD在高龄急性梗阻性化脓性胆管炎患者治疗中的应用  

Therapeutic application of DSA guided PTCD to elderly patients with acute obstructive suppurative cholangitis

作　　者：张辉[1] 徐新保[1] 何晓军[1] 刘承利[1] 张洪义[1] 

机构地区：[1]空军总医院肝胆外科,北京100142

出　　处：《临床军医杂志》2014年第4期344-346,共3页Clinical Journal of Medical Officers

摘　　要：目的总结数字减影血管造影(DSA)引导下经皮肝穿胆管引流术(PTCD)治疗高龄急性梗阻性化脓性胆管炎(AOSC)患者的临床效果。方法回顾性分析我院自1995年1月—2013年1月诊治的高龄急性梗阻性化脓性胆管炎患者150例,根据不同处理方式分为PTCD+手术治疗组(n=65)和急诊手术治疗组(n=85),分析两组治疗方法的疗效、并发症发生率、死亡率。结果术后并发症发生率在PTCD+手术治疗组和急诊手术治疗组分别为12.3%和36.5%(P<0.05),两组的患者死亡率分别为3.1%和14.1%(P<0.05),PTCD+手术治疗组明显低于急诊手术组。结论 DSA下经皮肝穿刺胆道引流术在治疗高龄急性梗阻性化脓性胆管炎患者中疗效确切,可明显改善术前全身状态,使急诊手术变为择期手术,减少并发症,降低病死率。Objective To summarize the clinical efficacy of digital subtraction angiography （DSA） guided percutaneous transhepatic cholangiographic drainage （PTCD） in the treatment of elderly patients with acute obstructive suppurative cholangitis （AOSC）. Methods A total of 150 elderly patients diagnosed as AOSC in Air Force General Hospital from Jan. 1995 to Jan. 2013 were ana- lyzed retrospectively. Patients were grouped as PTCD plus operation group （ n = 65 ） and emergency operation group （ n = 85 ） ac- cording to the therapeutic interventions they received. The treatment efficacy, complication related mortality and overall mortality were analyzed respectively. Results The incidences of operative complications in the PTCD plus operation group and the emergency operation group were 12.3% and 36.5% , respectively （P 〈 0.05） , while the overall mortality in the two groups were 3.1% and 14.1% , respectively （P 〈 0.05 ）. Conclusion DSA guided PTCD is an effective and well-tolerated treatment option for elderly patients with AOSC. It is able to improve the preoperative general condition and reduce the incidences of operative complications and overall mortality. Therefore it provides more chance of selective operations.

关 键 词：数字减影血管造影 经皮肝穿刺 胆道引流术 急性梗阻性化脓性胆管炎 

分 类 号：R575.7[医药卫生—消化系统]