超声引导经皮肝穿刺置管对口引流治疗胆管空肠Roux-en-Y吻合术后肝脓肿  

Ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage for liver abscess after Roux-en-Y hepaticojejunostomy

作　　者：张辉[1] 陈光宇[1] 陈琪[1] 汪涛[1] 

机构地区：[1]四川省成都军区总医院普通外科微创中心,四川成都610083

出　　处：《中国普通外科杂志》2015年第8期1150-1154,共5页China Journal of General Surgery

基　　金：全军临床高新技术重大基金资助项目(2010gxjs040);四川省青年科技创新研究团队资助项目(2011JTD0010)

摘　　要：目的：探讨超声引导经皮肝穿刺置管对口引流治疗胆管空肠Roux-en-Y吻合术后肝脓肿的临床效果。方法：回顾性分析2012年1月—2014年1月接受超声引导经皮肝穿刺置管对口引流治疗胆管空肠Roux-en-Y吻合术后肝脓肿的20例患者的临床资料。结果：20例患者均穿刺置管成功,置管后24-48 h疼痛症状缓解,48-72 h体温恢复正常,疼痛、寒战症状消失,72-96 h白细胞恢复到正常范围,且在持续引流过程中引流管未见堵管及引流不畅现象。带管时间为11 d至1个月,平均时间为14 d。20例患者均未出现出血、周围脏器损伤等严重并发症。结论：超声引导经皮肝穿刺置管对口引流是治疗胆管空肠Roux-en-Y吻合术后肝脓肿可靠、有效的方法。Objective： To evaluate the clinical efficacy of ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage for liver abscess after Roux-en-Y hepaticojejunostomy. Methods： The clinical data of 20 patients with liver abscess after Roux-en-Y hepaticojejunostomy undergoing ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage from January 2012 to January 2014 were retrospectively analyzed. Results： In all 20 patients, catheterization was successfully performed, the symptoms of pain were alleviated 24- 48 h after catheterization, body temperature returned to normal, and the symptoms of pain and chills disappeared 48-72 h after catheterization; white blood cell levels returned to normal range 72-96 h after catheterization, and no tube blockage or partial blockage occurred during the continuous drainage. The tube retention time ranged fiom 11 d to one month, with an average of 14 d. No serious complications such as hemorrhage or surrounding organ injuries were noted in any of the 20 patients. Conclusion： Interventional ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage is a reliable and effective management for liver abscess after Roux-en-Y hepaticojejunostomy.

关 键 词：肝脓肿/超声检查 引流术 穿刺抽液术 手术后并发症 

分 类 号：R575.4[医药卫生—消化系统]