超声引导下经皮肝穿刺胆管引流术治疗阻塞性黄疸的临床价值.pdf

《超声引导下经皮肝穿刺胆管引流术治疗阻塞性黄疸的临床价值.pdf》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、·494·中国介入影像与治疗学2012年第9卷第7期ChinJIntervImagingTher，2012，Vol9，No7Valueofultrasound—guidedpercutaneoustranshepaticcholangiodrainageinthetreatmentofobstructivejaundiceYANGNa，xlAYao—you，FENGLei，SUNYan，ZHANGShu，LlNCui—yun，yUQing，CHENKun，LUZhuo(DepartmentofUltrasound，theSecondA{filiatedHospit

2、alofKunmingMedicalCollege，Kumming650101，China)[Abstract]ObjectiveToobservethevalueofultrasound-guidedpercutaneoustranshepaticcholangiodrainage(PTCD)intreatmentofobstructivejaundice．MethodsTotally149obstructivejaundicepatientsunderwentPTCDundertheguidanceofcolorDopplerultrasound，includ

3、ing60patientswithbiliarycarcinoma，35withbiliarystones，28withpancreaticheadcancer，8withbiliarynarrowafteroperation，6withacutesuppurativecholangitis，7withgallbladdercarcinoma，3withperampullaryadenocarcinomaand2withpancreaticbodycancer．ComplicationsandthesuccessrateofPTCDwereana—lyzed．Re

4、sultsThesuccessrateofPTCDwas97．99(146／149)．Among146successfulcases，104werecarriedoutbypassthroughthebiliaryductoftheleftlaterallobe，34throughtherightbiliaryduct，8throughbothrightandleftbiliaryducts．PTCDwasfailedin3patientswithbiliarycarcinoma(3／149，2．01)，including2withtOOnarrowbiliary

5、ducttOpuncture，1terminatingoperationduetOcontinuingbileducthemorrhage．Thedrainage-tubesperformedwellduringfol—low—upforoneweektO18months，except3withtubesshedand1withbiliaryductinfection．NoseriouscomplicationsOC—eurred．ConclusionPTCDundertheguidancewithcolorDopplerultrasoundisconvenien

6、t，safeandeffectiveforthetreat—mentofobstructivejaundice．[Keywords]Jaundice，obstructive；Drainage；ultrasonography，Doppler，color超声引导下经皮肝穿刺胆管引流术治疗阻塞性黄疸的临床价值杨娜，夏要友，冯蕾，孙琰，张庶，林翠云，虞青，陈坤，刘卓(昆明医学院第二附属医院超声诊断科，云南昆明650101)[摘要]目的探讨超声引导下经皮经肝穿刺胆管引流术(PTCD)治疗阻塞性黄疸的临床应用价值。方法回顾性分析PTCD治疗149例阻塞性黄疸患者的成功率与并发

7、症，其中胆管癌6O例，胆管结石35例，胰头癌28例，手术后胆管狭窄8例，急性化脓性胆管炎6例，胆囊癌7例，壶腹周围癌3例，胰体癌2例。结果146例穿刺成功(146／149，97．99)，其中经肝左叶肝内胆管置管104例，经肝右叶肝内胆管置管34例，肝左叶及肝右叶肝内胆管均置管8例。3例穿刺失败，均为胆管癌(3／149，2．O1)，其中2例因肝内胆管内径纤细、穿刺路径过深而无法成功植入引流管；1例因穿刺胆管持续出血而被迫终止手术。穿刺术后随访1周～18个月，除3例患者出现引流管脱出、1例胆管感染外，其余病例均引流通畅，无明显并发症。结论彩色多普勒超声引导下PTCD治

8、疗阻塞性黄