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时间:2019-05-22
《彩超引导下PTCD治疗恶性梗阻性黄疸临床应用与分析》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、大理学院学报第13卷第2期2014年2BJOURNALOFDALIUNIVERSITYV0l_13No.2Feb.2014[DOI]10.3969/j.issn.1672-2345.2014.02.014’-‘‘-彩超引导下PTCD治疗恶性梗阻性黄疸临床应用与分析张国辉,程艳,李娟,陈玲,岳冬美,伍玉萍(大理学院曲靖教学医院,云南曲靖655000)[摘要]目的:探讨彩超引导下经皮经肝穿刺胆管引流术治疗恶性梗阻性黄疸的临床意义。方法:分析经皮肝穿刺胆道引流术治疗43/51例恶性阻塞性黄疸患者的成功率与并发症,其中胆管癌24例,胰头癌22例,
2、壶腹癌4例,手术后胆管狭窄1例。结果:47例穿刺成功(47/51,92.15%),其中经肝左叶肝内胆管置管40例,经肝右叶肝内胆管置管4例,肝左叶及肝右叶肝内胆管均置管3例。4例穿刺失败均为因肝内胆管内径纤细无法成功置入引流管;穿刺术后随访1周~12个月,1例胆管感染,1例随访3月死亡,其余病例均引流通畅,先明显并发症。结论:彩色多普勒超声引导下经皮肝穿刺胆道引流术治疗恶性阻塞性黄疸操作简便,安全、有效。[关键词]彩超;恶性梗阻性黄疸;经皮肝穿刺胆道引流术[中图分类号]R657.43[文献标志码]B[文章编号]1672—2345(2014
3、)02—0052—03ClinicalApplicationandAnalysisofUltrasound--GuidedPTCDintheTreatmentofMalignantObstructiveJaundiceZHANGGuohui,CHENGYah,LIJuan,CHENLing,YUEDongmei,WUYuping(QujingTeachingHospitalofDaliUniversity,Qujing,Yunnan655000,China)[Abstract]Objective:Toexploretheclinicals
4、ignificanceofultrasound—guidedpercutaneoustranshepaticcholangiographyanddrainage(PTCD)inthetreatmentofmalignantobstructivejaundice.Methods:TheSuccessrateandcomplicationsof51patientswithobstructivejaundice(24casesofcholangiocarcinoma,22casesofpancreaticcancer,4casesofampul
5、larycarcinoma,1caseofpostoperativebiliarystricture)wereexamined.Results:Forty—sevencasesweresuccessfullyoperated(47/51,successrate92.15%),40casesofintrahepaticbileductcatheterwerefromlefthepaticlobe,4caseswerefromrightlobeand3casesofintrahepaticbileductcatheterwereinlefto
6、rfighthepaticlobe.Therewere4casesfailedduetothesmallinnerdiameterofintrahepaticbileducts.Infollowedupfor1weekto12months,1casewerebiliaryinfection,1casediedin3month,theremainingcaseswerefoundunobstructeddrainageandnoobviouscomplications.Conclusion:ColorDopplerultrasound—gu
7、idedPTCDwassimple,safeandeffectiveinthetreatmentofmalignantobstructivejaundice.【Keywords)ultrasound;CDFI;PTCD经皮肝穿刺胆道引流术(percutaneoustranshep.1资料与方法ticcholangiographyanddrainage,PrI’CD)是一种微创1.1一般资料本组患者51例,男23例,女28的诊疗方法,在肝胆胰外科疾病的治疗中使用日益例。年龄43~81岁,平均56岁。胆管癌24例,胰头普遍,尤其在恶性梗阻性黄
8、疽姑息治疗方面,通畅癌22例,壶腹癌4例,手术后胆管狭窄1例。临床表的引流能很快缓解恶性梗阻性黄疸患者肝内胆管现均有明显黄疸及不同程度的消瘦、皮肤瘙痒,右的压力,消退黄疸,改善肝功能和全身状况
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