单纯DSA引导与DSA联合彩超引导在经皮肝穿胆道引流术治疗胆管癌伴恶性梗阻性黄疸患者中的临床研究  

Clinical study on only DSA guided and DSA combined with color Doppler ultrasound guided in percutaneous transhepatic cholangial drainage for patients with cholangiocarcinoma complicated with malignant jaundice

作　　者：陆晓[1] 尹治清 秦方方[1] 蒋明[1] 段成洲 LU Xiao;YIN Zhi-qing;QIN Fang-fang;JIANG Ming;DUAN Cheng-zhou(Department of interventional radiology,Tumour Hospital of Anyang,Anyang,Henan,45500)

机构地区：[1]安阳市肿瘤医院介入科,河南安阳455000

出　　处：《医药论坛杂志》2018年第9期35-38,共4页Journal of Medical Forum

摘　　要：目的研究单纯数字减影血管造影(DSA)引导与DSA联合彩超引导在经皮肝穿胆道引流术(PTCD)治疗胆管癌伴恶性梗阻黄疸患者中的临床效果。方法选取安阳市肿瘤医院2015年1月至2017年12月收治的60例胆管癌伴恶性梗阻黄疸患者,按随机数字表法分组,各30例。均采取PTCD治疗,对照组给予单纯DSA引导,观察组采取DSA联合彩超引导。比较两组穿刺情况、透视时间、手术用时、手术前后肝功能[血清直接胆红素(DBIL)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)]及并发症发生情况。结果观察组穿刺成功率为100%,与对照组73. 33%相比,差异明显(P <0. 05);观察组穿刺次数少于对照组,透视时间、手术用时短于对照组(P <0. 05);术前两组血清DBIL、ALT、TBIL、AST水平无明显差异(P> 0. 05);两组术后3 d血清DBIL、ALT、TBIL、AST水平较术前降低,观察组术后3 d血清DBIL、ALT、TBIL、AST下降程度高于对照组(P <0. 05);观察组并发症发生率3. 33%低于对照组20. 00%,差异有统计学意义(P <0. 05)。结论与单纯DSA引导相比,胆管癌伴恶性梗阻黄疸患者PTCD治疗中采取DSA联合彩超引导可有效避免穿刺失败,减少穿刺次数,缩短透视及手术时间,且并发症少。Objective To investigate the clinical effect of only digital subtraction angiography（ DSA） guided and DSA combined with color Doppler ultrasound guided in percutaneous transhepatic cholangial drainage for patients with cholangiocarcinoma complicated with malignant jaundice. Methods Totally 30 cases of Cholangiocarcinoma with malignant jaundice admitted to Tumour Hospital of Anyang from January 2015 to December 2017 were randomly divided into groups with 30 cases in each. All patients were treated with PTCD,while the control group was guided by DSA only,and the observation group was guided by DSA combined with color Doppler ultrasound. The puncture conditions,fluoroscopy time,operation time,liver function before and after operation [serum direct bilirubin（ DBIL）,alanine aminotransferase（ ALT）,total bilirubin（ TBIL）,aspartate aminotransferase（ AST） ]and complications of two groups were compared.Results The success rate of puncture in the observation group was 100%,which was significantly different from that in the control group（ 73. 33%）（ P〈0. 05）. The puncture times in the observation group were less than those in the control group,and the time of fluoroscopy and operation was shorter than thate in the control group（ P〈0. 05）. There was insignificant difference in serum levels of DBIL,ALT,TBIL and AST between the two groups before operation（ P〉0. 05）. The serum levels of DBIL,ALT,TBIL and AST of the two groups decreased after 3 d of operation,and the degree of descent of serum DBIL,ALT,TBIL and AST in the observation group were higher than those in the control group after 3 d of operation（ P〈0. 05）. The incidence of complications in the observation group（ 3. 33%） was lower than that in the control group（ 20%）,and the difference was statistically significant（ P〈0. 05）. Conclusion Compared with only DSA guidance,DSA combined with color Doppler ultrasound guidance during percutaneous transhepatic cholangial drainage in the treatment of Cholangiocarcinoma w

关 键 词：胆管癌伴恶性梗阻黄疸 经皮肝穿胆道引流术 DSA 彩超 

分 类 号：R730.41[医药卫生—肿瘤] R735.8[医药卫生—临床医学]