PTBD技术在胆系疾病中的应用  

Application of PTBD in Biliary Disease

作　　者：赵夏夏[1] 王银[1] 柴福禄[2] 李荣梓[2] 李红梅[2] 史建华[2] 

机构地区：[1]解放军第一医院特诊科,甘肃兰州730030 [2]兰州军区兰州总医院肝胆科

出　　处：《中国医学影像技术》2003年第9期1173-1174,共2页Chinese Journal of Medical Imaging Technology

摘　　要：目的　评价经皮肝胆道引流术 (PTBD)在胆系疾病中的应用价值。方法　对 13例不能手术的胆道梗阻患者行PTBD术 ,其中肝门部胆管阻塞 4例 ,胆总管下段梗阻 9例。结果　 13例共行 15例次PTBD ,11例 ( 13例次 )置管引流成功 ,手术成功率 86.6% ( 13 /15 ) ,成功置管的 13例次中 1次穿刺成功率 84.6% ( 11/13 )。成功手术的 11例患者术后 1周黄疸明显减退者 8例 ( 72 .7% ) ,血浆胆红素下降至 5 g/L以下 ,2例血浆胆红素较术前有下降 ,但仍高于 5 g/L( 2 .5 % ) ,1例无明显减退。结论　PTBD能有效地降低不能手术治疗的胆系阻塞患者的血浆胆红素 ,已被临床证实为阻塞性黄疸患者术前减轻黄疸与姑息性治疗的有效方法。Objective To evaluate the treatment value of percutaneous transhepatic biliary drainage (PTBD) in biliary disease. Methods Thirteen patients (M∶F, 5∶8, mean age 53 years) with obstructive jaundice underwent PTBD. Four patients had hilar cholangiocarcinoma and nine patients had the distal common bile duct obstruction. PTBD was performed under ultrasound guidance. Resuluts Fifteen times of PTBD were performed in 13 patients and 13 times was successfully performed in 11 patients (13/15, 86.4%). Among these, 84.6% (11/13) of the plastic stents were successfully dislodged one time. After PTBD, the serum bilirubin levels were decreased obviously (<5g) in 8 patients (72.7%) and decreased slightly (>5g/L) in two patients. Conclusion PTBD can decrease the serum bilirubin level effectively in the patients with obstructive jaundice. It can be applied preoperatively in cases with severe jaundice to decrease the serum bilirubin level or as a palliative treatment method in the inoperable patients with obstructive jaundice. [

关 键 词：经皮肝胆道引流术 胆道梗阻 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.7[医药卫生—诊断学]