超声引导下经皮肝穿刺胆管置管引流术治疗梗阻性黄疸.pdf

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1、·782·中国介入影像与治疗学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，FirstAffil

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超声引导下经皮肝穿刺胆管置管引流术治疗梗阻性黄疸魏炜，艾红，阮骊韬，赵巧玲，杨锦茹，尹益民，任晓萍，潘文倩(西安交通大学医学院第一附属医院超声影像科，陕西西安710061)[摘要]目的探讨超声引导下经皮肝穿刺胆管置管引流术治疗梗阻性黄疸的临床价值。方法对39例梗阻性黄疸患者行超声引导下经皮肝穿刺胆管置管引流术，包括胆管癌23例，胰头癌9例，化脓性胆管炎伴胆管结石4例，壶腹部肿瘤3例。结果行右肝管穿刺24例，左肝管穿刺10例，同时行左右

7、肝管穿刺5例。所有患者均一针穿刺成功，成功率i00；术后血清总胆红素、直接胆红素、碱性磷酸酶、丙氨酸转氨酶和7一谷氨酰转移酶均显著下降(P均dO．05)。结论超声引导下经皮肝穿刺胆管置管引流术具有定位准确、操作简便、创伤小、并发症少等优点，能在短期内有效降低体内胆红素水平，对于肝功能的恢复及后续治疗具有一定临床价值。[关键词]超声引导；梗阻性黄疸；经皮肝穿刺胆管置管引流术[中图分类号]R445．1；R575[文献标识码]A[文章编号]1672—8475(2012)11—0782—04胆道梗阻可造成血中结合胆红素及总胆红素显著衰竭等一系列并发症_1]。

8、解除梗阻及胆管减压是治疗升高及肝肠循环障碍，导致体内内毒素堆积，严重者可的关键。超声引导下经皮肝穿刺胆管置管