超声引导下胆道系统引流管更换技术的应用分析  

Application and clinical evaluation of ultrasound-guided biliary drainage tube replacement technology

作　　者：张安红[1,2] 张瑞昕[3] 马杰 邱博[2] 伊鑫[2] 鲁志华[2] 郑立杰[2] 董汉光[2] 韩田 张丽 姜远辉[2] 徐钧[1] ZHANG Anhong;ZHANG Ruixin;MA jie;QIU Bo;YI Xin;LU Zhihua;ZHENG Lijie;DONG Hanguang;HAN Tian;ZHANG Li;JIANG Yuanhui;XU Jun(Department of Hepatobiliary and Pancreatic Surgery and Liver Transplant Center,The First Hospital of Shanxi Medical University,Taiyuan 030000,China;Department of General Surgery,Qilu Hospital of Shandong University,Qingdao,Shandong 266035,China;School of Basic Medicine,Shanxi Medical University,Taiyuan 030000,China;The First Clinical Medical College,Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第一医院肝胆胰外科及肝脏移植中心,太原030000 [2]山东大学齐鲁医院普外科,山东青岛266035 [3]山西医科大学基础医学院,太原030000 [4]山西医科大学第一临床医学院,太原030000

出　　处：《临床肝胆病杂志》2022年第11期2542-2545,共4页Journal of Clinical Hepatology

基　　金：山西省科学技术厅中央引导地方专项(YDZJSX2021B012)。

摘　　要：目的总结超声引导下胆道系统引流管更换的初步应用结果,提出相应的技术要点,探讨操作策略及临床应用价值。方法采用回顾性分析方法收集2014年8月—2020年8月山东大学齐鲁医院收治的60例通过超声引导下进行胆道系统引流管更换的患者的临床资料,对操作过程以及术后并发症进行分析,对操作技术和临床应用进行总结。结果60例患者中,沿原窦道成功完成引流管更换58例,成功率96.67%,其中扩张窦道置入粗级别引流管47例,置入原型号引流管11例。平均操作时间为15.8(12.0~19.0)min,需用局部麻醉剂。28例为PTCD引流,23例为胆囊引流,9例为T管引流,均引流胆汁。术后观察引流情况,均较前好转,有效率100%,术后回访未见明显异常。结论超声引导下引流管更换简便、安全、可行,为其在临床中进一步推广提供了数据支持。Objective To summarize the preliminary application results of ultrasound-guided biliary drainage tube replacement,present the corresponding technical points,and discuss the operation strategy and clinical application value.Methods The clinical data of 60 patients who underwent ultrasound-guided biliary drainage tube replacement in Qilu Hospital of Shandong University between August 2014 and August 2020 were retrospectively analyzed.The operation procedure,clinical applications,and postoperative complications were summarized and analyzed.Results Fifty-eight of the 60 patients(96.67%)were successfully replaced with drainage tubes along the original sinus.Among them,dilated sinus tracts of 47 patients were placed with coarse-grade drainage tubes,and dilated sinus tracts of the remaining 11 patients were placed with the original type of drainage tubes,with the mean operation time of 15.8(12.0-19.0)min under local anesthesia.In total,bile was drained from 28 patients receiving PTCD drainage,23 patients receiving gallbladder drainage,and 9 patients receiving T-tube drainage.The post-operation evaluation revealed that the drainage situation has improved,with a 100%effective rate.No obvious abnormality was found in the postoperative follow-up visit.Conclusion The replacement of drainage tube under ultrasound guidance is simple,safe and feasible,and it provides further promotion in clinical practice with sufficient data support.

关 键 词：超声检查 介入性 胆道外科手术 引流术 穿刺术 引流管 

分 类 号：R657.4[医药卫生—外科学]