文档介绍：三维超声引导下PTCD治疗恶性阻塞性黄疸的临床价值探讨
作者:彭莉晴,李明星, 邹庆伟
【摘要】目的探讨在三维超声引导下经皮肝胆管穿刺置管引流术对治疗恶性阻塞性黄疸的临床价值。方法回顾性分析35例恶性梗阻性黄疸病人在三维超声引导下行PTCD术的临床资料,对首次穿刺成功率,置管成功率,以及术前、术后两周的肝生化指标进行分析。结果35例患者共行36次PTCD,其中l例首次穿刺失败,%(35/36);置管成功率100%;术后2周患者症状、体征均明显改善,表现为黄疸减轻,皮肤瘙痒缓解,情绪好转,食欲增加,~~,无严重并发症发生。结论三维超声下导向穿刺首次穿刺成功率和置管成功率高,术后并发症发生率低;对不宜手术的恶性阻塞性黄疸病人是较好的选择,值得临床推广应用。
【关键词】三维超声;恶性梗阻性黄疸;经皮肝胆管穿刺置管引流
AbstractObjectiveTo probe into the clinical value of 3-D ultrasound-guided PTCD for malignant obstructive clinical data of 35 cases of malignant obstructive jaundice treated by 3-D ultrasound-guided PTCD were retrospectively first puncture ess rate and intubation ess rate as well as hepatic biochemical criterion preoperatively and 2 weeks postoperatively were was performed 36 times in 35 these,the first puncture failed in first puncture ess rate was %(35/36)and
the intubation ess rate 100%.The symptoms and signs of the patients ameliorated significantly 2 weeks postoperatively,presenting with a reduction in jaundice,remission of cutaneous pruritus,emotional improvement,an increase in an appetite,a derease in serum total bilirubin from ~ preoperatively to ~ 2weeks postoperatively and no -dimensional ultrasound-guided PTCD has high puncture and intubation ess rates and a low incidence rate of is a better choice for patients with malignant obstructive jaunce unsuitable for operation and worth application and dissemination.
KEYWORDSthree-dimensional ultrasoundmalignant obstructive jaundicePTCD
临床部分晚期恶性肿瘤所致的阻塞性黄疸患者已无手术指征,如果不能将胆汁引流,患者将会因肝功能衰竭或其他并发症而危及生命。现采用在三维超声引导下经皮经肝胆管穿刺置管引流术(percutaneous transhepatic cholangiographic drainage,PTCD),可使患者减轻黄疸症状,改善生活质量,延长生命。本文通过回顾性分析2007~2009年,我科对35例恶性梗阻性黄疸患者实施三维超声导向下的PTCD术,探讨其操作应用和临床价值。
1资料与方法
35例均为2007年1月~2009年12月的我院住院患者。男性21例,女性14例。年龄47~87岁,平均67岁。临床主要表现