实时双平面超声成像引导下PTCD术的应用价值

Application value of real-time double-plane ultrasound in guiding percutaneous transhepatic cholangiographic drainage

目的探讨实时双平面超声成像引导下行经皮肝胆管穿刺置管引流术(PTCD)的应用价值。方法对152例梗阻性黄疸患者行超声引导下PTCD,共穿刺173支胆管,其中57支由实时双平面超声成像引导完成,116支在二维超声引导下操作。对两种引导方法下的穿刺时间、首次穿刺成功率、置管成功率进行比较。结果实时双平面超声引导下PTCD术的穿刺时间短于二维超声引导(P<0.05),在胆管内径<5mm时首次穿刺成功率为92.00%(23/25),明显高于二维超声引导下穿刺成功率(27/41,65.85%)。置管成功率差异无统计学意义(P>0.05)。术后均无严重并发症发生。结论实时双平面超声成像导向PTCD术穿刺时间短,对于胆管内径<5mm者,首次穿刺成功率高,优于二维超声下导向穿刺,具有较好的临床应用价值。

Objective To observe the value of real-time double plane ultrasound in the guidance of percutaneous transhepatic cholangiographic drainage（PTCD）.Methods PTCD was performed on 152 patients with obstructive jaundice under guidance of ultrasound.Totally 173 branches of bile duct were punctured,of which 57 were guided with real-time double plane ultrasound and 116 guided with two-dimensional（2D） ultrasound.The time of puncture,the success rate of single puncture and catheter placement were compared between the two methods.Results Puncture time of real-time double plane imaging guidance PTCD was less than that of 2D ultrasound guidance（P0.05）.For patients with inner diameter of bile duct smaller than 5 mm,the success rate of first puncture was 92.00%（23/25）,higher than that of 2D ultrasound guidance（27/41,65.85%）.The success rate of catheter placement had no statistical difference between the two methods（P0.05）.No severe complications occurred after PTCD.Conclusion Real-time double plane ultrasound guiding PTCD took shorter puncture time,and the first success rate of puncture was superior to that of 2D ultrasound guidance puncture in bile duct smaller than 5 mm,therefore it has good clinical application value.