超声定位结合DSA引导下经皮肝穿刺胆道引流术在恶性梗阻性黄疸中的应用  

Application of Percutaneous Transhepatic Choledochus Drainage in Malignant Obstruction Jaundice Guided by Ultrasound Localization Combined with DSA

作　　者：彭卫军[1] 陈爱民[1] 蒋寒[1] 周红艳[1] 张海青[1] 

机构地区：[1]湖北省潜江市中心医院放射科,湖北潜江433100

出　　处：《临床医学工程》2015年第10期1273-1275,共3页Clinical Medicine & Engineering

摘　　要：目的评价超声定位结合DSA引导下经皮肝穿刺胆道引流术在恶性梗阻性黄疸中的应用价值。方法收集我院恶性梗阻性黄疸患者48例,随机分成实验组和对照组各24例,实验组在超声定位结合DSA引导下穿刺行经皮肝穿刺胆道引流术,对照组在DSA引导下穿刺行经皮肝穿刺胆道引流术,观察比较两组的临床效果、术后并发症发生率。结果实验组穿刺成功率为100.0%(24/24);对照组穿刺成功率为91.7%(22/24),2例失败者采用超声定位结合DSA引导下穿刺成功。实验组1例患者胆道轻微出血,并发症发生率为4.2%;对照组5例患者胆道出血,4例患者胆汁性腹膜炎,并发症发生率为37.5%;两组并发症发生率相比差异显著(P<0.01)。两组比较,实验组穿刺次数、透视时间及手术时间均明显少于对照组(P<0.01);两组患者术后的疗效率、半年生存率及一年生存率相比差异无统计学意义(均P>0.05)。结论超声定位结合DSA引导下穿刺行经皮肝穿刺胆道引流术治疗恶性梗阻性黄疸能够提高穿刺的成功率,减少穿刺次数及手术时间,降低并发症的发生,值得临床推广。Objective To evaluate the application value of percutaneous transhepatic choledochus drainage （PTCD） in malignant obstruction jaundice （MOJ） guided by ultrasound localization combined with DSA. Methods 48 MOJ patients in our hospital were collected and randomly divided into experimental group and control group, with 24 cases in each group. The experimental group was implemented PTCD guided by ultrasound localization combined with DSA, the control group was implemented PTCD guided by DSA. The clinical effect, incidence of postoperative complications were observed and compared. Results The success rate of puncture of experimental group was 100.0%（24/24）;the success rate of puncture of control group was 91.7%（22/24）, 2 cases who failed puncture were punctured successfully under the guidance of ultrasound localization combined with DSA. The incidence of complications of experimental group was 4.2%, with slight hematobilia in one case;the incidence of complications of control group was 37.5%, with hematobilia in 5 cases and bile peritonitis in 4 cases; the incidence of complications of experimental group was lower than that of control group （P 〈0.01）. The puncture times, fluoroscopy time and operation time of experimental group were significantly shorter than those of control group （P〈0.01）;the effective rate, half year and one-year survival rate of two groups had no statistical difference （both P〉0.05）. Conclusions PTCD can improve the success rate of puncture in treatment of malignant obstructive jaundice under the guidance of ultrasound localization combined with DSA, and can reduce the puncture times and operation time, reduce the incidence of complications, which is worthy of promotion in clinic.

关 键 词：经皮肝穿刺胆道引流术 梗阻性黄疸 超声 介入治疗 

分 类 号：R587.1[医药卫生—内分泌] R774.1[医药卫生—内科学]