B超引导门脉穿刺的临床应用

Clinical Application of PTP under the Guidance of B-mode Ultrasound

本文报告B超引导门脉穿刺16例,13例穿刺成功,3例失败,穿刺成功率81.25%。文章介绍了B超引导门脉穿刺的方法,临床应用及效果,总结了其优越性,并对引导穿刺中存在的问题进行了探讨。认为B超引导PTP,对于门脉高压患者能清淅显示门脉系统及门体循环,并可于体外测门脉压力,为临床明确诊断及手术方案的选择提供可靠依据。B超引导门脉穿刺亦可作为急诊栓塞治疗的途径,对于胰岛细胞瘤患者,通过分段测脾静脉血胰岛素浓度,推测胰岛细胞瘤的所在部位,弥补了体外B超探测时胰岛细胞瘤不易清晰显示及手术探查亦不易触及的不足。

The percutaneous transhepatic portal centesis under the guidance of B ultrasound was carried out in sixteen patients. Thirteen cases were successful. The rate of success is up to 81.25 %. It is introduced prominently about the procedures of PTP under the guidance of B ultrasound, and its clinical application and therapic results. It also summed up its superiority and investigated the problems during the centesis. The study showed that the portal venous system and portalsystemic circulation in patients with portal hypertension can be used for the extracorporal measurement of portal venous pressure. It might be a dependable basis for the clinical diagnosis and the choice of surgical procedures, PTP can be used in patients with insulinoma to postulate the location of insulinoma by means of measuring the concentration of insulin level in different part of the splenic vein. It makes up for the insufficiency in the dectation of the location of insulinoma which could not be showed easily by the extracorporal use of routine B ultrasound and by palpation during operation.