摘要
目的探讨多侧孔导管在胆道梗阻性疾病介入操作术中的应用价值。方法接受PTCD术治疗的513例梗阻性黄疸患者,经皮肝穿刺胆道成功后,将导丝送过狭窄段,再交换成多侧孔导管,通过多侧孔导管完成胆道造影、保留通路;导丝过狭窄段胆道角度不良者,采用导管侧孔协助导丝调整角度,通过狭窄段胆道;高位胆道梗阻,多支胆道狭窄者,用多侧孔引流管跨越多支狭窄胆管,增加引流量。结果所有患者经多侧孔导管注入对比剂均一次性完成胆道全程造影,显示胆道情况,并有效保留插管建立的完整胆道通路。其中12例患者,采用导丝经导管侧孔协助过狭窄段胆道,完成通路建立,15例高位胆道梗阻患者使用多侧孔引流管实现多支胆管引流,提高了引流效果。术后1周TB(血清总胆红素)均值由术前(312.3±53.6)umol/l降至(231.1±36.3)umol/l,P<0.01。344例患者黄疸症状得到改善,明显好转116例,53例黄疸症状改善不明显。结论在PTCD术中使用多侧孔导管,可简化操作程序,缩短操作时间;也可以跨胆管引流,提高引流效果。
Objective To investigate the clinical value of multi-side hole catheter in intervention operation of biliary obstructive disease. Methods 513 cases of obstructive jaundice were accepted percutaneous transhepatic cholangial drainage treatment. The guide wire over the narrow section of biliary tract was successfully sent after percutaneous transhepatic puncture biliary, then, the multi--side hole catheter was exchanged. The cholangio-graphy with the multi-side hole catheter was completed and the pathway was retained. The lateral holes of catheter was used to assist the guide wire for adjusting the angle of guide wire through the biliary narrow section, then passed through pathway. The multi-side hole catheter across multiple stricture-bile processes was used for upper or multi--vessel obstructive jaundice in order to increase the drainage of bile. Results All patients were completed the entire biliary duct imaging to show biliary duct situation with the multi--side hole catheter at onetime and the integrity of biliary duct pathway was retained. In 12 cases, the lateral holes of catheter was performed to assist the guide wire through biliary stricture to establish the pathways. In 15 cases with upper obstructive jaundice the multi-side hole catheter was used to complete the multivessel drainage. Conclusion Using multi-side hole catheter in PTCD during the operation could not only simplify the operation procedure and shorten the operation time, but also cross multi-vessel drainage and improve the drainage effect.
出处
《医学影像学杂志》
2013年第6期921-923,共3页
Journal of Medical Imaging
关键词
梗阻性黄疸
介入治疗
胆道引流
Obstructive jaundice
Interventional therapy~ Biliary drainage
