超声引导下经皮经肝胆管穿刺置管引流51例治疗总结.docVIP

精品论文 参考文献 超声引导下经皮经肝胆管穿刺置管引流51例治疗总结 靳根峰（通讯作者） 冯建超 刘勇 郭富安 李玉凤 （河南省新郑市人民医院普外科 451100） 【摘要】目的 探讨超声下经皮经肝胆管穿刺置管引流术在梗阻性黄疸的临床应用价值。方法 应用彩色多普勒超声引导对51例梗阻性黄疸患者进行经皮经肝胆管穿刺置管引流术，并将治疗结果进行分析。结果 51例梗阻性黄疸患者总成功率为94.1％（48/51），一针穿刺成功率达88.2％（45/51）。穿刺胆管直径范围4-11mm。平均直径为6.5mm，术后胆汁引流量平均为620ml/d ，并发症发生率为0.5％。结论 彩色超声引导下的经皮经肝胆管引流术穿刺置管简便、安全、成功率高，可作为治疗梗阻性黄疸外引流的有效方法。 【关键词】 经皮经肝胆管引流术 梗阻性黄疸 【中图分类号】R615 【文献标识码】A 【文章编号】2095-1752（2013）25-0093-02 UItrasound-guided percutaneous transhepatic bile drainage in 51 patients JIN Gen-feng，FENG Jian-chao,LIU Yong. Xinzheng People Hospital,Xinzheng 451150,China 【Abstruct】 Objective To determine the clinical value of ultrasound-guided percutaneous transhepatic bile drainage （UPTBD）in treatment of obstructive jaundice. Methods UPTBD was performed in 51 patients with obstructive jaundice and tube was inserted to the biliary duct in all patients. Results Among the 51 patients,the overall success rate was 94.1％（48/51）,and the success rate of single centesis was 88.2％（45/51）.The diameter of biliary duct ranged from 4mm to 11mm,the mean diameter was 6.5mm,the mean amount of daily bile drainage was 620ml ,and the rate of complication was 0.5％(3/51). Conclusions UPTBD is an effective alternative for bile duct drainage,with advantages of minimal invasion,simple performance ,little pain ,and a high success rate. Hence it is an important method for the treatment of biliary obstructive diseases. 【Key worts】 Percutaneous transhepatic bile drainage Biliary obstructive diseases 超声引导下经皮经肝胆管穿刺置管引流（ultrasound-guided percutaneous transhepatic biledrainage UPTBD）在临床中已经得到广泛运用，如何提高穿刺置管成功率，减少并发症，提高引流质量也随之成为大家所关注的问题。[1-3]2008年6月至2012年3月我们运用常规超声探头引导下UPTBD治疗51例患者，现总结报道如下： 资料和方法 一、一般资料 本组病例51例，男32例，女19例，年龄21-79岁，平均53.2岁。其中胰头癌25例，胆管癌16例，壶腹周围癌7例，胆管结石3例。 二、方法 术前常规检查血常规、肝肾功能及凝血功能，确定属穿刺置管指征。运用AlskSSD 680型彩色超声仪、3.5 MHz扇形探头，7.2Fr 带线rho;型引流套管，先行超声检查，选择目标胆管，目测进针方向，确定腹壁穿刺点，消毒铺