PTCD治疗急性梗阻性化脓性胆管炎的临床疗效分析

Analysis of Curative Effect of PTCD in the Treatment of Acute Obstructive Suppurative Cholangitis

目的:探讨急诊超声联合(数字减影血管造影)DSA下经皮肝穿刺胆管引流术(PTCD)治疗急性梗阻性化脓性胆管炎(AOSC)的临床疗效分析。方法:回顾性分析某院60例急诊PTCD治疗AOSC患者的临床疗效及并发症。结果:60例患者超声联合DSA下PTCD穿刺成功率为100%,4例出现严重并发症。56例(93.3%)患者PTCD置管引流后2~5d梗阻症状明显好转,胆红素明显下降。2例(3.3%)患者住院期间死亡。其中45例患者在感染控制后行手术解除梗阻病因后疗效满意;无法手术治疗的13例患者带管生存,带管时间3~14个月,平均6个月。结论:对AOSC的患者进行急诊PTCD治疗能及时解除梗阻,同时改善症状,且安全可靠。

Objective： To explore the curative effect of PTCD under ultrasound combined DSA in the treatment of acute obstructive suppurative cholangitis （AOSC）.Methods.The therapeutic effects and complications of 60 patients with AOSC in a hospital were analyzed retrospectively. Results： The success rate of PTCD under ultrasound combined DSA was 100% ,and there were 4 patients with severe complications happened.The obstruction symptoms of 56 patients were disappeared after 2-5d after PTCD treatment,and the bilirubin level was decreased significantly. There were 2 patients （3.3 %） died during hospitalization.There 45 patients got satisfied effects after relieved the obstruction etiology by surgery when the patients＇ infection were controlled. 18 cases of patients who cannot be treated with operation were living with drainage tube, and the period of living with drainage tube was 3- 14 months,with an average of 6 months.Conclusion： Emergency treatment of PTCD is helpful and reliable for patients with AOSC to relieve the obstruction timely, and can improve the symptoms at the same time.