超声引导肝内胆管穿刺在老年高位恶性胆道梗阻中的应用

发布时间：2018-03-03 05:20

  本文选题：恶性胆道梗阻　切入点：超声检查　出处：《中国介入影像与治疗学》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨超声引导下肝内胆管穿刺联合DSA胆道双支架植入内引流治疗老年高位恶性胆道梗阻(MHBO)的临床应用价值。方法收集老年MHBO患者108例,超声组54例在超声引导下行肝内胆管穿刺,DSA组54例在DSA下行肝内胆管盲穿;2组患者穿刺成功后,于DSA下视情况行胆道双支架植入内引流、胆道单支架植入并对侧外引流、胆道完全外引流及优势侧胆道外引流;分析2组患者肝内胆管穿刺、近期并发症及4种胆道引流方式的疗效。结果超声组患者胆管穿刺次数、穿刺对比剂用量、胆道出血及穿刺点疼痛发生率明显小于DSA组(P均0.05),1次穿刺成功率明显高于DSA组(P0.05)。4种胆道引流方式术后第14天肝功能指标及术后第21天总胆红素(TBIL)值组间两两比较差异均有统计学意义(P均0.05)。结论超声引导穿刺技术联合DSA胆道双支架植入内引流治疗老年MHBO有明显的临床实用价值。
[Abstract]:Objective to investigate the clinical value of ultrasound guided intrahepatic bile duct puncture combined with double stent drainage of DSA biliary tract in the treatment of high malignant biliary obstruction in the elderly. Methods 108 cases of elderly patients with MHBO were collected. After successful puncture of intrahepatic bile duct under DSA, 54 patients in the ultrasound group underwent double stent drainage under DSA, single stent implantation and contralateral external drainage. Total external drainage of biliary tract and external drainage of dominant side of bile duct were analyzed in two groups of patients with intrahepatic bile duct puncture, short-term complications and 4 kinds of biliary drainage methods. Results the times of bile duct puncture and the dosage of puncture contrast agent were analyzed in ultrasonic group. The incidence of biliary bleeding and pain at puncture point was significantly lower than that in DSA group (P < 0.05). The successful rate of puncture was significantly higher than that in DSA group on the 14th day after operation and the value of total bilirubin TBIL on the 21st day after operation. Conclusion Ultrasound-guided puncture combined with double-stent drainage of DSA biliary tract is of great clinical value in the treatment of elderly patients with MHBO.
【作者单位】： 河北医科大学第四医院放射科;
【分类号】：R445.1;R730.5
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本文编号：1559714