B超引导下多孔猪尾管置管引流的临床应用

Clinical study of percutaneous transhepatic bile duct drainage with multiple opening pig -tail tube guided by B - mode ultrasound

目的 采用姑息性手段解除晚期恶性肿瘤病人的胆道阻塞,提高病人生活质量。方法 32例壶腹部占位、胆囊占位伴肝门部转移、胰头占位及胆总管占位病人,通过专用超声穿刺探头及18号穿刺针将自制多孔猪尾管置入病人扩张的胆管内并保留。结果 穿刺后一周,肝内外胆管的直径分别由穿刺前的0.65±0.10cm、1.85±0.22cm下降为0.35±0.08cm、1.02±0.12cm;血清直接胆红素由穿刺前的52.28±5.93μmol/L下降为10.68±1.57μmol/L。穿刺前后相比,p<0.05。同时病人的临床症状有显改善。结论 方法简便,穿刺命中率高,无明显副作用,经济实用。具推广应用价值。

Purpose To relieve the pains and improve the life quality of the patients with obstructive jaundice caused by malignant tumors in late stage by means of percutaneous transhepatic bile duct drainage guided by B - mode ultrasound. Methods All of 51 patients suffered from malignant tumors of gall bladder, pancreas, common bile duct and Vater s ampulla in late stage. The pig - tail tube with multiple holes was inserted by the puncture transducer and the 18G needle. Results The intra - and extra - hepatic bile duct reduced from 0.65 ± 0.10cm, 1.85 ± 0.22cm before placement to 0.35 ± 0.08cm, 1.22 ± 0.12cm one week after the drainage, respectively. And the direct bilirubin in sirum changed from 52.78 ± 5. 93μmol/L to 15.68 ± 1.57μmol/L, too. Comparing the observative parameters in this group, the marked level is P< 0.05. Clinical signs of patients were improved. Conclusions This is an easy and effective way to treat the patients with obstructive jaundice caused by malignant tumors in late stage, needs less cost and has no obvious side - effect. It has a promising future in clinical practice.