超聲引導(dǎo)下經(jīng)皮肝穿刺膽管置管引流術(shù)治療梗阻性黃疸.pdf

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1、·782·中國(guó)介入影像與治療學(xué)2012年第9卷第11期ChinJIntervImagingTher，2012，Vol9，No11Ultrasound—guidedpercutaneoustranshepaticch0langi0graphicdrainageintreatmentofobstructivejaundiceEIWei，AIHong，RUANLi—tao，ZHAOQiao—ling，YANGJin—r“，YINYi-min，RENXiao—ping，PANWen—qian(DepartmentofUltrasound，F(xiàn)irstAffil

2、iatedHospitalofMedicalCollegeofXi'anJiaotongUniversity，Xi'an710061，China)[Abstract]0bjectiveToobservetheclinicalvalueofultrasound-guidedpercutaneoustranshepaticcholangiographicdrainage(PTCD)forthetreatmentofobstructivejaundice．MethodsPTCDwasperformedundertheguidanceofultra—soun

3、din39patientswithobstructivejaundice，including23withcholangiocarcinoma，9withpancreaticheadcarcinoma，4withsuppurativecholangitiscomplicatedwithbileductcalculi，and3withampullarysulcustumor．ResultsPTCDwassuccessfullyperformedthroughrighthepaticductin24patients，throughlefthepaticdu

4、ctin10andthroughbothductsin5patients．Amongallpatients，thesuccessfulrateforonesessionwas100．Theserumlevelsoftotalbilirubin，directbilirubin，alkalinephosphatase，alanineaminotransferaseand7-glutamyltransferasesignificantlydecreasedinallthepa—tientsafterPTCD(allP

5、rasound—guidedPTCDhasadvantagessuchasaccuratepositioning，sim—pleoperation，minimalinvasion，fewercomplicationsandSOon，andcanreducethe1evelofbilirubininshortterm，thushavingcertainclinicalvaluefortherecoveryofliverfunctionandsubsequenttreatment．FKeywords~Ultrasound—guided；Obstructi

6、vejaundice；Percutaneoustranshepatiecholangiographicdrainage超聲引導(dǎo)下經(jīng)皮肝穿刺膽管置管引流術(shù)治療梗阻性黃疸魏煒，艾紅，阮驪韜，趙巧玲，楊錦茹，尹益民，任曉萍，潘文倩(西安交通大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院超聲影像科，陜西西安710061)[摘要]目的探討超聲引導(dǎo)下經(jīng)皮肝穿刺膽管置管引流術(shù)治療梗阻性黃疸的臨床價(jià)值。方法對(duì)39例梗阻性黃疸患者行超聲引導(dǎo)下經(jīng)皮肝穿刺膽管置管引流術(shù)，包括膽管癌23例，胰頭癌9例，化膿性膽管炎伴膽管結(jié)石4例，壺腹部腫瘤3例。結(jié)果行右肝管穿刺24例，左肝管穿刺10例，同時(shí)行左右

7、肝管穿刺5例。所有患者均一針穿刺成功，成功率i00；術(shù)后血清總膽紅素、直接膽紅素、堿性磷酸酶、丙氨酸轉(zhuǎn)氨酶和7一谷氨酰轉(zhuǎn)移酶均顯著下降(P均dO．05)。結(jié)論超聲引導(dǎo)下經(jīng)皮肝穿刺膽管置管引流術(shù)具有定位準(zhǔn)確、操作簡(jiǎn)便、創(chuàng)傷小、并發(fā)癥少等優(yōu)點(diǎn)，能在短期內(nèi)有效降低體內(nèi)膽紅素水平，對(duì)于肝功能的恢復(fù)及后續(xù)治療具有一定臨床價(jià)值。[關(guān)鍵詞]超聲引導(dǎo)；梗阻性黃疸；經(jīng)皮肝穿刺膽管置管引流術(shù)[中圖分類號(hào)]R445．1；R575[文獻(xiàn)標(biāo)識(shí)碼]A[文章編號(hào)]1672—8475(2012)11—0782—04膽道梗阻可造成血中結(jié)合膽紅素及總膽紅素顯著衰竭等一系列并發(fā)癥_1]。

8、解除梗阻及膽管減壓是治療升高及肝腸循環(huán)障礙，導(dǎo)致體內(nèi)內(nèi)毒素堆積，嚴(yán)重者可的關(guān)鍵。超聲引導(dǎo)下經(jīng)皮肝穿刺膽管置管