超声引导经皮经肝穿刺胆管置管引流治疗晚期恶性梗阻性黄疸

The Therapy of Advanced Malignant Biliary Obstructive Jaundice of PTCD Under Ultrasonic Transducer

目的 探讨超声引导经皮经肝穿刺胆管置管引流（percutaneous transhepatic cholangial drainage，PTCD）治疗晚期恶性梗阻性黄疸的临床应用价值。方法 晚期恶性梗阻性黄疸28例，在B超引导下采用静脉导管施行胆管置管引流。结果 28例1次置管成功率96.43%（27/28），2次置管成功率100%（1/1），引流量360～800 mL/d，1周后血清总胆红素降至85.5～170.1μmol/L。结论 超声引导经皮经肝穿刺胆管准确性高、灵活、安全、实时。采用静脉导管置管引流安全实用，价格低廉，值得推广。

Objective To study the clinical value of percutaneous transhepatic cholangial drainage （PTCD） under ultrasonic transducer in the treatment of advanced malignant biliary obstructive jaundice. Methods Twenty-eight patients with advanced malignant biliary obstructive jaundice underwent PTCD with vein catheter under ultrasonic transducer. Results The success rate of a single puncture was up to 96.4% （27/28） , and that of two-times puncture was 100% （28/28） , The number of drainage was up to 360 - 800 mL/d, and the number of serum total bilirubin draw to 85.5 - 170.1 μmol/L after a week. Conclusions The accuracy rate of the ultrasonic transducer percutaneous transhepatic cholangial puncture was very high and has the advantages as being flexible,safe,and dynamically synchronous. PTCD with vein catheter was safe, useful and cheap. It should be used broadly.