普通探头引导经皮经肝胆管引流术在梗阻性黄疸中的应用分析

Clinical Application of Percutaneous Transhepatic Bile Drainage Guided by Ordinary Ultrasonic Probe in Patients with Obstructive Jaundice

目的 :探讨普通探头引导经皮经肝胆管穿刺置管引流术(PTBD)在梗阻性黄疸治疗中的应用价值 ,并分析导致操作失败的原因。方法 :梗阻性黄疸患者121例 ,全部行PTBD ,并观察血清总胆红素的变化及治疗情况。结果 :成功穿刺置管119例(包括双侧穿刺置管单侧成功病例) ,穿刺置管144例次 ,129例次1次成功 ,PTBD1次穿刺置管成功率89.5%(129/144)。术后1周黄疸明显减退率为80.7 % ,2周减退率为95.8 % ,无严重并发症出现。结论 :PTBD具有方便灵活的特点 ,在梗阻性黄疸治疗方面具有重要的临床价值。操作时如能对常见置管失败原因加以预防 ,会进一步提高PTBD的成功率 。

Objective:To probe the clinical application of percutaneous transhepatic bile drainage(PTBD)guided by ordinary ultrasonic probe in patients with obstructive jaundice.Methods:One hundred and twenty-one patients with extrahepatic jaundice underwent PTBD,and the changes of serum total bilirubin level were observed.Results:Among144punctures in121patients,129(89.5%)puncture were succeeded at one time.The significant decrease rates of serum total bilirubin level were80.7%in one week and95.8%in two weeks.There was not a severe complication in all patients.Conclusion:PTBD guided by ordinary ultrasonic probe is convenient and flexible and has an important significance in treatment of patient with obstructive jaundice.If the cause of failure was analyzed every time,the success rate can be improved and the side effects can be deˉcreased.