摘要
目的分析X线透视联合超声实时引导下经皮肝穿胆道引流术(PTBD)治疗阻塞性黄疸的操作技术及其应用价值。方法 78例阻塞性黄疸患者,其中70例为恶性阻塞性病变,8例为良性阻塞性病变,在超声实时引导结合X线透视下行PTBD术,穿刺右叶胆管52例,穿刺左叶胆管26例,并常规造影。结果所有患者手术均获得成功,未出现大出血及胆汁性腹膜炎等并发症,术后梗阻性黄疸症状逐渐改善,术后1～2周血清胆红素及转氨酶水平较术前明显下降(P<0.01)。结论 X线透视结合超声实时引导下PTBD是一种治疗阻塞性黄疸的有效方法,具有安全、简便、经济、并发症少的优点。
Objective To investigate the technical and clinical value of percutaneous transhepatic biliary drainage （PTBD） in treating patients of obstructive jaundice with the help of fluoroscopic and realtime ultrasound monitoring. Methods A total of 78 patients with obstructive jaundice were enrolled in this study. The primary lesions included malignant diseases （n = 70） and benign diseases （n = 8）. PTBD was carried out in all patients. Under fluoroscopic and real-time ultrasonography guidance, the biliary duct of the right hepatic lobe （n = 52） or the biliary duct of the left hepatic lobe was punctured and the cholangiography was routinely performed. The drainage procedure was carried out. Results PTBD was successfully accomplished in all patients. No severe complications, such as massive bleeding or biliary peritonitis, occurred. After the treatment the symptoms and signs of obstructive jaundice were gradually improved. The serum levels of both bilirubin and transaminase determined 1 - 2 weeks after the treatment were decreased, and the reductions were statistically significant when compared with the preoperative data （P 〈 0.01 ）. Conclusion For the obstructive jaundice, PTBD under the guidance of fluoroscopy and realtime ultrasonography is an effective, safe, simple and economical treatment with fewer complications. （J Intervent Radiol, 2012, 21.. 309-313）
出处
《介入放射学杂志》
CSCD
北大核心
2012年第4期309-313,共5页
Journal of Interventional Radiology
关键词
阻塞性黄疸
超声实时引导
X线透视
经皮肝穿胆道引流术
obstructive jaundice
real-time ultrasound guidance
fluoroscopy
percutaneous transhepatic biliary drainage
