经皮胆道支架置入术的超声引导置管的临床研究

The Clinical Study on PTBD Guided by Ultrasound in the Patients treated with Metallic Biliary Stent

目的对经皮胆道支架的超声引导置管方法进行探讨。方法对51例接受经皮胆道支架置放术的患者的临床资料进行分析。结果单独穿刺右前支胆管29例,单独穿刺左外支胆管10例,左右胆管同时置管12例。胆道支架置放成功46例,成功率90.2%。经右侧胆管放置40例,成功38例,其中2例为先经左侧胆管放置失败后再经右侧胆管放置成功;经左侧胆管放置14例,成功8例,其中1例为先经右侧胆管放置失败后再经左侧胆管放置成功者。一次性经右侧及左侧放置支架成功率分别94.7%和53.9%,二者相比差异显著(P<0.01);所用时间(分钟)分别为(32.8±12.4)及(46.2±11.3),二者相比差异显著(P<0.01)。结论右肝二、三级胆管应该为穿刺置管的首选,左右胆管同时置管可提高支架放置成功率。

Objective To explore the method of percutanoues transhepatic biliarry drainage（PTBD） guided by ultrasound in the patients treated with metallic stent placement.Methods The clinic data of 51 patients treated with metallic biliary stent were analyzed.Results Catheters were placed into the right bile duct in 29 patients,and into the left bile duct in 10 patients.Catheters were placed into both of the right and the left bile duct in 12 patients.Metallic stent were successfully inserted in 46 patients,and the successful rate was 90.2 percent.Successful rate of stent placement through right and left bile duct were 94.7 percent and 53.9 percent,and the procedure time of stent placement were（32.8±12.4） and（46.2±11.3） minutes respectively.Conclusion The second and the third grade of right biliary duct are the ideal position to be punctured.It is beneficial for metallic stent placement to insert catheters in both right and left biliary duct simultaneously.