超声引导经皮经肝穿刺胆管引流术100例应用观察  

Application of ultrasound-guided percutaneous transhepatic bile duct drainage in 100 cases

作　　者：何颖韬[1] 谢丽丹[1] 周海萍[1] 卢伟业 陈方红[1] He Yingtao;Xie Lidan;Zhou Haiping;Lu Weiye;Chen Fanghong(Department of Ultrasound,Lishai Central Hospital,Lishui,Zhejiang 323000)

机构地区：[1]丽水市中心医院超声科,浙江省323000

出　　处：《中国基层医药》2019年第18期2235-2238,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：探讨超声引导经皮经肝穿刺胆管引流术的临床应用效果.方法选取2016 年6月至2018年6月丽水市中心医院收治的梗阻性黄疸患者100例,对其采用超声引导经皮经肝穿刺胆管引流术,对患者的穿刺成功率和术后并发症进行分析.结果 100例患者中,98例穿刺成功,成功率为98%,2例失败,失败率为2%.在肝内胆管内径为0.5~2.0 cm患者一次性穿刺置管成功率(98.91%)明显高于肝内胆管内径为0.3~0.4 cm的患者(87.50%),两种不同直径穿刺置管相比,差异有统计学意义(χ^2 =12.369,P<0.05).对98例穿刺成功的患者进行术后回访可知,2例患者出现引流管脱出、2例患者出现胆管感染,剩余患者均引流通畅,无明显并发症.结论超声引导经皮肝穿刺胆管引流术对于治疗恶性肿瘤引起的阻塞性黄疸,该方式操作简单易上手,且安全可靠,治疗效果明显,在临床上具有一定价值,值得推广和使用.Objective To investigate the clinical effect of percutaneous transhepatic bile duct drainage guided by ultrasound.Methods From June 2016 to June 2018,100 patients with obstructive jaundice in Lishui Central Hospital were treated with ultrasound -guided percutaneous transhepatic bile duct drainage.The success rate and postoperative complications of the patients were analyzed.Results Among 100 cases,98 cases were successful , 2 cases failed,and the failure rate was 2%.The success rate of one -time catheterization in 0.5-2.0 cm patients with intrahepatic bile duct diameter (98.91%) was significantly higher than that in intrahepatic bile duct diameter 0.3-0.4 cm patients(87.50%),compared with two different diameter puncture catheterization ,the difference was statistically significant (χ^2 =12.369, P <0.05 ).All 98 cases with successful puncture were followed up after operation (P<0.05),and there was no statistically significant difference between the two groups ( P<0.05).The drainage tube was removed in 2 cases,bile duct infection was found in 2 cases,the remaining patients were unobstructed, and there were no obvious complications.Conclusion Ultrasound-guided percutaneous transhepatic catheterization and drainage for the treatment of obstructive jaundice caused by malignant tumor is simple ,reliable,safe and effective, and has a certain clinical value.It is worthy of popularizing and application.

关 键 词：引流术 胆管 穿刺术 肝 超声检查 

分 类 号：R657.4[医药卫生—外科学]