经皮肝胆管引流术对梗阻性黄疸的疗效观察及其并发症原因分析

Effects of percutaneous transhepatic biliary drainage for malignant obstructive jaundice and analysis of reason of its complication

[目的 ]探讨经皮肝穿刺胆道外引流术对恶性梗阻性黄疸的疗效及其并发症的预防和处理 .[方法 ]回顾性总结用介入性经皮肝穿胆道外引流术治疗的恶性梗阻性黄疸 16例的临床资料 ,观察术前术后血清胆红素变化 ,分析并发症的发生原因及预防措施 .[结果 ]16例经皮肝胆管引流术均 1次性成功 ,术后 1～ 2周 ,总胆红素平均下降 112 87μmol/L ,直接胆红素平均下降 6 6 4 2 μmol/L ,并发症有引流管出血、脱落、阻塞、胆汁外漏、发烧和感染性休克等 .[结论 ]经皮肝胆管引流术治疗恶性梗阻性黄疸的近期疗效满意 ,对不宜行外科手术的阻塞性黄疸是一种安全且有效的方法 ,但应严格掌握适应症 ,预防和控制并发症 .

OBJECTIVE?To study the therapeutic effects of percutaneous transhepatic biliary drainage(PTBD) for malignant obstructive jaundice and the prevention and treatment of its complication.?METHODS?The clinical data of 16 cases of malignant of obstructive jaundice operated by PTBD were retrospectively summarized, and the changes of preoperative and postoperative serum bilirubin were observed and the cause of the complication and the preventive measures was analyzed.?RESULTS?The PTBD in 16 cases was succeed in a lump. Total bilirubin decreased to average out to 112 87?μmol/L and direct bilirubin was 66 42?μmol/L after 1 or 2 weeks of operation. The complication of PTBD had bleeding, drainage tube shedding, bile leakage, drainage tube emphraxis, fever and infectious shock, and so on.?CONCLUSION?The efficacy of PTBD for malignant obstructive jaundice is apparent in the near future, the PTBD is a safe and effective methods for obstructive jaundice that is unsuitable for surgical treatment.