双导丝技术在经皮胆囊穿刺引流术中的应用

发布时间：2018-02-15 22:29

本文关键词： 急性胆囊炎经皮胆囊穿刺引流体层摄影术 X线计算机　出处：《临床放射学杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的探讨双导丝技术在经皮胆囊穿刺引流术中的应用价值及临床疗效。方法回顾性分析2012年2月至2014年4月采用双导丝技术进行经皮穿刺胆囊引流术的48例高危急性胆囊炎患者资料,其中36例为结石性胆囊炎,12例为非结石性胆囊炎;34例行经皮经肝穿刺引流,14例行经腹腔胆囊穿刺引流;4例在DSA引导下行经皮胆囊穿刺引流术,44例在CT引导下行经皮胆囊穿刺引流术。引流管直径为8F,引流管拔出前给予闭管1周。结果 48例患者均成功置入外引流管,操作成功率为100%。1例合并急性心功能衰竭患者死亡。1例术后第3天突发腹痛,CT显示小肠破裂,行小肠破裂修补术后治愈。1例术后第3天腹痛复发,行胆囊造影显示引流管破裂,更换引流管后好转,其余47例患者术后引流通畅,术后72 h腹痛等症状减轻或消失,体温及白细胞降至正常。19例结石性胆囊炎患者术后1~3个月行择期胆囊切除术,17例结石性胆囊炎患者选择带管生存,12例非结石性胆囊炎患者术后6~7周拔管。结论双导丝技术在经皮胆囊穿刺引流术中具有操作简单、创伤小、安全性高、疗效确切的优点,具有重要临床应用价值。
[Abstract]:Objective to investigate the value and clinical effect of double wire technique in percutaneous cholecystectomy. Methods 48 cases of high risk patients with percutaneous cholecyst drainage by double wire technique from February 2012 to April 2014 were analyzed retrospectively. Data of patients with acute cholecystitis, 36 cases of cholecystitis were calculous cholecystitis 12 cases were non-calculous cholecystitis 34 cases were treated by percutaneous transhepatic cholecystitis and 14 cases by celiac cholecystitis and 4 cases by DSA guided percutaneous cholecystitis drainage 44 cases were performed under CT guidance. Percutaneous cholecystectomy was performed. The diameter of the drainage tube was 8F, and the tube was given for 1 week before the tube was pulled out. Results all the 48 patients were successfully implanted with the external drainage tube. The successful rate of operation was 100.1 cases of acute heart failure. 1 cases died of sudden abdominal pain on the 3rd day after operation. Ct showed rupture of small intestine, 1 cases were cured after small intestinal rupture repair, and 1 cases of abdominal pain recurred on the third day after operation. Gallbladder angiography showed rupture of drainage tube. After the replacement of drainage tube, the other 47 patients were relieved or disappeared after operation, and the abdominal pain was alleviated or disappeared 72 hours after operation. Body temperature and white blood cells dropped to normal. 19 patients with cholecystitis underwent elective cholecystectomy 1 ~ 3 months after operation. 17 patients with cholecystitis underwent elective cholecystectomy and 12 patients with noncalculous cholecystitis underwent extubation after 67 weeks. The technique of guiding wire is easy to operate in percutaneous transhepatic cholecystectomy. The advantages of small trauma, high safety and definite curative effect have important clinical application value.
【作者单位】：青岛市第八人民医院介入科;青岛大学附属医院放射科;
【分类号】：R575.6;R816.5

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