彩超引导经皮穿刺肝胆管引流术治疗梗阻性黄疸

Clinical Application of Obstructive jaundice by Color Doppler Ultrasound-guided Percutaneous Transhepatic Cholangial Drainage Treatment

目的:探讨彩超引导下经皮肝穿刺胆管引流术治疗梗阻性黄疸的临床价值。方法:梗阻性黄疸80例患者在彩超引导下行PTCD,置管90根,观察置管情况,治疗前后谷丙转氨酶(ALT),肿瘤坏死因子-α(TNF-α)水平变化和并发症。结果:PTCD80例,1次成功率95.5%,2次成功率100%;引流管放置时间5～15d;并发症4例(5.0%);术后ALT含量(85.33±32.78)U/L,明显低于术前(188.60±105.56)U/L(t=2.889,P<0.01);术后TNF-α含量(104.32±19.59)pg/mL与术前(108.58±19.95l)pg/mL无显著性差异(t=1.839,P>0.05)。结论:彩超引导下PTCD是治疗梗阻性黄疸最为有效的方法。

Objective：To investigate the clinical value of color Doppler ultrasound-guided percutaneous transhepatic cholangial drainage （PTCD） treatment obstructive jaundice.Methods：PTCD was performed in 80 patients of obstructive jaundice caused by biliary calculi,carcinoma of gallbladder,The 90 drainage were carried out in all the cases.The contents of Alanine aminotransferase（ALT）and Tumor necrosis factor-α（TNF-α）before and after treatment and complications were observed.Results：The successive rate of single puncture of bile duct was to 95.5%,that of twice drainage was 100%.Tube were inserted to the target biliary for 5～15days.The complications were happened in 4 caces（5.0%）;The contents of ALT （85.33±32.78）U/L after surgery were significantly lower than before surgery （188.60±105.56）U/L（t=2.889,P0.01）;The contents of TNF-α（104.32±19.59）pg/mL after surgery with before surgery （108.58±19.95l）pg/mL were no significant difference（t=1.839,P0.05）.Conclusions：Ultrasound Guided PTCD treatment obstructive jaundice were most effective method.