彩色多普勒超声在行经皮肝行胆道内支架置入术中的价值探讨

Evaluation of the clinical value of the color doppler ultrasound in percutaneous biliary stenting line

目的：探讨彩色多普勒超声在经皮肝行胆道内支架置入术中的临床应用价值。方法在彩色多普勒超声辅助下对68例梗阻性黄疸的患者进行经皮肝胆道内支架置入术的操作，其中恶性梗阻性黄疸患者59例，良性梗阻性黄疸的患者9例。单侧胆管扩张5例，双侧胆管同时扩张63例。扩张胆管内径3-18mm ，平均5．8mm 。其中61例患者进行了单侧的胆道支架置入术，7名患者进行了双侧胆道支架置入术，共计置入胆道支架75次。在术后复查相关实验室指标，及彩色多普勒超声检查，并与术前的结果进行比较。结果在这68例75次需行经皮肝胆道内支架植入术的梗阻性黄疸患者中，有71次一次性成功地置入了支架，占全部病例的95％；其余4例在第一次操作失败后，再择期进行第二次置入胆道支架，二次成功率为100％。术后所有患者的相关实验室指标均有好转，胆管无明显扩张，彩色多普勒超声可以清晰地观察到置入的胆道金属支架，在其引导下无一例严重并发症发生。结论彩色多普勒超声在经皮肝行胆道内支架置入术中有着非常重要的临床价值。

Objective To evaluate the clinical value of color Doppler ultrasound in percutaneous biliary stenting line . Methods With the aid of color Doppler ultrasound ,intradermal biliary tract stenting operation was conducted in 68 pa‐tients with obstructive jaundice ,in which 59 cases were malignant obstructive jaundice patients and 9 were benign obstruc‐tive jaundice .There were five cases of unilateral have bile duct dilatation and 63 cases of bilateral bile duct dilatation .The inner diameter of the bile ducts was 3 - 18 mm ,with an average of 5 .8 mm .Of those patients ,61 were subjected to uni‐lateral biliary stenting ,seven to both biliary stenting ,with a total of 75 times of biliary stent placements .Postoperatively , relevant laboratory parameters and color Doppler sonography were performed and compared with the preoperative results . Results Of those 75 times of biliary stent placements on the 68 patients who required for percutaneous biliary stenting ,71 times were conducted successfully by once ,accounting for 95% ;the first operation on the remaining four cases were failed and then a second elective operation was successfully performed ,with secondary success rate of 100% .Related laboratory indicators had been improved in all patients after surgery ,no significant biliary dilatation was revealed ,and color Doppler ultrasound can clearly observe the biliary metallic stent placement , with no serious complications .Conclusion Color Doppler ultrasound in percutaneous biliary stenting line has a very important clinical value .