老年非结石原因阻塞性黄疸的超声诊断及介入治疗.docVIP

老年非结石原因阻塞性黄疸的超声诊断及介入治疗 【摘要】 目的:探讨老年非结石原因阻塞性黄疸患者的超声诊断及介入治疗(超声引导下经皮经肝胆道穿刺置管引流术)价值。方法:51例62岁以上阻塞性黄疸患者(男32例，女19例)，经超声检查并手术证实或CT/MR检查未发现结石，其中23例采用超声引导的经皮肝胆道穿刺置管引流术(PTBD)术治疗。结果：所有病例超声均能确诊为阻塞性黄疸，病因诊断正确率为77.5%(31/40)，PTBD均1次穿刺成功，无显著并发症发生，患者黄疸迅速缓解消退。结论：超声对老年人各种非结石原因阻塞性黄疸患者具有较高的诊断价值；对于不宜手术治疗及术后复发患者，超声引导下PTBD是一种比较安全、简便、经济的治疗老年非结石原因阻塞性黄疸的方法。 【关键词】 老年；阻塞性黄疸；超声；经皮经肝胆道穿刺置管引流术 　　Application of Ultrasonophy in Diagnosis and Interventional Therapy of Nonconcretion Obstructive Jaundice in Elderly Patients 　　ZHENG Baoqun,LIN Teng,WANG Chubin 　　(The First Affiliated Hospital of Medical College of Shantou University ，Shantou，Guangdong 515041,China) 　　Abstract：Objective To evaluate the ultrasonophy in diagnosis and interventional therapy (ultrasound guided percutaneous transhepatic biliary drainage)of nonconcretion obstructive jaundice in elderly patients.Methods 51 patients over 62 with obstructive jaundice had US,CT and (or)MRCP, and finded no concretion. PTBD was perforded in 23 patients of them.Results All patients were diagnosed,and 77.5% patients can found the cause through ultrasound diagnosis. The puntures succeeded once in all 23 patients. The effect of draining was satisfied without severe complication,and the jaundice of all the patients was relaxed and subsided.Conclusion Ultrasound is effective in diagnosis of nonconcretion obstructive jaundice in elderly patients. The Ultrasound Guided Percutaneous Transhepatic Biliary Drainage(PTBD) is an operation which is simple,direct,safe,inexpensive,and effective in cure of nonconcretion obstuctive jaundice in elderly patients. 　　Key words：The elderly;Obstuctive Jaundice;Ultrasonophy;Percutaneous Transhepatic Biliary Drainage(PTBD) 　　我院于1996年至2006年间超声诊断老年非结石原因阻塞性黄疸住院患者51例，其中40例病经手术病理证实，23例行超声引导下经皮经肝穿刺胆道引流术 (Percutaneous Transhepatic Biliary Drainage,PTBD )治疗，取得较好效果。 　　1 资料与方法 　　1.1 临床资料 老年非结石原因阻塞性黄疸51例中男32例，女19例，年龄62岁～79岁，平均年龄68.6岁。肝内左右胆管同时扩张39例，单纯左胆管扩张9例，单纯右胆管扩张3例，胆总管扩张37例，内径8 mm～