数字减影血管造影引导下经皮经肝胆管引流术治疗急性梗阻性化脓性胆管炎临床分析  

Clinical analysis of digital subtraction angiography-guided percutaneous transhepatic cholangial drainage in treatment of acute obstructive suppurative cholangitis

作　　者：沈为光 江晓冬 梁黎 金杰[1] SHEN Weiguang;JIANG Xiaodong;LIANG Li;JIN Jie(Department of Interventional,the Second Affiliated Hospital of Nantong University,Nantong,Jiangsu Province 226001,China)

机构地区：[1]南通大学第二附属医院介入科,江苏南通226001

出　　处：《实用放射学杂志》2025年第1期106-109,共4页Journal of Practical Radiology

基　　金：南通市卫生健康委员会科研项目(QNZ2022018)。

摘　　要：目的探讨在数字减影血管造影(DSA)引导下经皮经肝胆管引流术(PTCD)治疗急性梗阻性化脓性胆管炎(AOSC)的临床疗效。方法收集在DSA引导下行PTCD治疗的AOSC患者相关资料,分析其安全性及有效性。结果70例患者中出血2例,引流管堵塞1例,引流管脱落1例,无其他严重手术相关并发症发生。66例患者于PTCD后3~7 d症状均较术前改善,4例患者住院期间死亡。患者每日平均胆汁引流量为(650±130)mL,手术前后白细胞、总胆红素、谷丙转氨酶、碱性磷酸酶指标变化差异有统计学意义(P<0.05)。结论DSA引导下PTCD治疗AOSC是一项技术成功率高、安全且有效的微创方法,能及时解除梗阻、改善症状、降低死亡率,为二期外科手术或介入治疗创造机会和条件。Objective To investigate the clinical effect of digital subtraction angiography(DSA)-guided percutaneous transhepatic cholangial drainage(PTCD)in treatment of acute obstructive suppurative cholangitis(AOSC).Methods The relevant data of DSAguided PTCD in treatment of AOSC patients were collected to analyze its safety and effectiveness.Results Among the 70 patients,there were 2 cases of bleeding,1 case of drainage tube blockage,and 1 case of drainage tube detachment,and no other serious surgical related complications occurred.The symptoms of 66 patients were improved from 3 to 7 d after PTCD compared with those before PTCD,and 4 patients died during hospitalization.The average daily bile drainage volume of patients was(650±130)mL,and the changes of leukocyte,total bilirubin,alanine aminotransferase and alkaline phosphatase indexes before and after surgery were statistically significant(P<0.05).Conclusion DSA-guided PTCD in treatment of AOSC is a safe and effective minimally invasive method with high technical success rate,which can timely relieve obstruction,improve symptoms,reduce mortality,and create opportunities and conditions for secondary surgery or interventional therapy.

关 键 词：数字减影血管造影 经皮经肝胆管引流术 急性梗阻性化脓性胆管炎 

分 类 号：R814.43[医药卫生—影像医学与核医学] R815[医药卫生—放射医学] R575.7[医药卫生—临床医学]