超声造影在经皮经肝胆道引流术中应用的临床意义  

Clinical significance of application of contrast enhanced ultrasound to percutaneous transhepatic biliary drainage

作　　者：胡勇飞[1] 周芝兰[1] 章雅琴[2] 

机构地区：[1]国防科学技术大学医院影像科,湖南长沙410073 [2]中南大学湘雅三医院影像科,湖南长沙410013

出　　处：《临床军医杂志》2014年第8期793-795,848,共4页Clinical Journal of Medical Officers

基　　金：湖南省自然科学基金(编号:10JJ5060)

摘　　要：目的探讨超声造影在经皮经肝胆道引流术中的临床应用价值。方法选取本院2010年1月—2013年1月诊治的梗阻性黄疸患者53例,行经皮经肝胆道引流术治疗,通过胆道引流管注入超声造影剂行超声造影检查,同时给予患者常规超声检查,比较两种检查方法的诊断价值,分析患者相关指标的变化情况(总胆红素、血清碱性磷酸酶、血清γ-谷氨酰转移酶)。结果超声造影检查的显示准确率(100.0%)明显高于常规超声检查(88.7%),差异有统计学意义(P<0.05)。两种检查方法在显示患者胆管梗阻程度时差异有统计学意义(P<0.05)。引流后随着时间的延长,患者总胆红素、血清碱性磷酸酶、血清γ-谷氨酰转移酶均呈现出明显的下降趋势,治疗前、治疗后1、2、4周相互比较差异均有统计学意义(P<0.05)。结论超声造影在经皮经肝胆道引流术中可清晰显示患者的胆管梗阻程度和提高显示准确率。Objective To investigate the clinical application of contrast enhanced ultrasound to percutaneous transhepatic biliary drainage. Methods A total of 53 patients with obstructive jaundice diagnosed and treated from January 2010 to January 2013 were enrolled in the study. They underwent percutaneous transhepatic biliary drainage. Ultrasound contrast agent was injected via biliary drainage tube, and routine ultrasound examination was also performed. Diagnostic values of the two methods were compared. Chan- ges in related indexes （total bilirubin, serum alkaline phosphatase, serum gamma glutamyltransferase） were analyzed. Results The display accuracy of contrast enhanced ultrasonography（ 100.0% ） was significantly higher than that of routine ultrasound exami- nation （ 88.7% ） , with a statistically significant difference （ P 〈 0.05 ）. The difference in displaying obstruction degree of bile duct between the two inspection methods was statistically significant （P 〈 0.05）. With the extension of time, total bilirubin, serum al- kaline phosphatase and serum gamma glutamyltransferase showed significantly downward trends, which were statistically significant when compared among before treatment, 1-,2- and 4 weeks after treatment （ P 〈 0.05）. Conclusion Contrast enhanced uhra- sound can clearly display the degree of biliary obstruction via percutaneous transhepatic biliary drainage, and significantly improve the accuracy rate of display.

关 键 词：超声造影 常规超声 经皮经肝胆道引流术 梗阻性黄疸 

分 类 号：R445.1[医药卫生—影像医学与核医学]