经胆管超声造影在超声引导下经皮肝穿刺胆道引流中的价值  

Value of intra-biliary contrast-enhanced ultrasound in ultrasound-guided percutaneous transhepatic cholangial drainage

作　　者：范晓翔[1] 章美武[1] 吕淑懿 庄鲁辉 张燕[1] Fan Xiaoxiang;Zhang Meiwu;Lyu Shuyi;Zhuang Luhui;Zhang Yan(Department of Interventional Therapy,Ningbo Second Hospital,Ningbo 315010,China)

机构地区：[1]宁波市第二医院医院介入治疗科,浙江宁波315010

出　　处：《中华医学超声杂志（电子版）》2023年第3期332-336,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：浙江省医药卫生科技计划(2019KY175,2023KY277);宁波市影像医学临床医学研究中心(2021L003);医学影像学-省市共建重点学科(2022-S02)。

摘　　要：目的探讨经胆管超声造影在经皮肝穿刺胆道引流术(PTCD)中的应用价值。方法回顾性分析2020年1月至2021年7月宁波市第二医院收治的210例胆道梗阻行超声引导下PTCD的患者,根据术中是否行经胆管超声造影分为对照组(101例)和造影组(109例),采用χ^(2)检验比较2组手术成功率、并发症发生率及退黄疗效的差异。结果2组手术成功率均为100%,造影组术后总的并发症发生率为8.3%(9/109),略高于对照组(5.0%,5/101),但2组差异无统计学意义(P>0.05)。退黄疗效方面,造影组退黄无效者3例(2.8%,3/109),对照组退黄无效者15例(14.9%,15/101),造影组退黄疗效优于对照组,差异具有统计学意义(χ^(2)=10.29,P=0.006)。结论PTCD术中应用IB-CEUS可以指导引流策略,获得更好的退黄疗效。Objective To evaluate the value of intra-biliary contrast-enhanced ultrasound(IB-CEUS)in percutaneous transhepatic cholangial drainage(PTCD).Methods A retrospective analysis was conducted on 210 patients with biliary obstruction who underwent ultrasound-guided PTCD at Ningbo Second Hospital from January 2020 to July 2021.The patients were divided into a control group(101 cases)and a contrast group(109 cases)based on whether IB-CEUS was performed.The differences in surgical success rate,incidence of complications,and efficacy in treating jaundice were compared between the two groups by the chi-square test.Results The success rate was 100%in both groups.The total incidence of postoperative complications in the contrast group was 8.3%(9/109),slightly higher than that of the control group(5.0%,5/101),but there was no statistically significant difference between the two groups(P>0.05).In terms of efficacy,there were 3 cases(2.8%,3/109)of ineffectiveness in reducing jaundice in the contrast group,and 15 cases(14.9%,15/101)in the control group.The contrast group had significantly better efficacy in reducing jaundice than the control group(χ^(2)=10.29,P=0.006).Conclusion The use of IB-CEUS during PTCD surgery can guide drainage strategies and achieve better efficacy in reducing jaundice.

关 键 词：超声造影 胆管 经皮肝穿刺胆道引流 胆道梗阻 

分 类 号：R445.1[医药卫生—影像医学与核医学] R657.4[医药卫生—诊断学]