胆道联合静脉超声造影在恶性梗阻性黄疸中的价值

发布时间：2018-07-29 20:28

【摘要】：目的:评价胆道联合静脉超声造影检查在恶性梗阻性黄疸治疗中的临床价值。方法:43例患者经增强CT或MRI诊断为恶性梗阻性黄疸,在手术前行经皮经肝胆管穿刺置管,并予以常规超声、静脉超声造影和胆道超声造影检查。以手术结果为金标准,分析常规超声、静脉超声造影、胆道超声造影、胆道联合静脉超声造影对恶性梗阻性黄疸的诊断符合率。结果:43例患者中,常规超声、静脉超声造影、胆道超声造影、胆道联合静脉超声造影的诊断符合率分别为72.1%(31/43)、83.7%(36/43)、81.4%(35/43)及93.0%(40/43)。其中胆道联合静脉超声造影的诊断符合率明显优于常规超声(P=0.021),而单独的静脉或胆道超声造影与常规超声之间的差异无统计学意义(P=0.194和0.307)。结论:胆道联合静脉超声造影可全面评估梗阻部位胆管的腔内和腔外的情况,提高超声对恶性梗阻性黄疸诊断符合率,有效判断手术的可切除性,具有较好的临床价值。
[Abstract]:Objective: to evaluate the clinical value of choledochography combined with venography in the treatment of malignant obstructive jaundice. Methods 43 patients with malignant obstructive jaundice were diagnosed by enhanced CT or MRI. Percutaneous transhepatic bile duct catheterization was performed before operation. Routine ultrasound, venography and cholangiography were performed. The diagnostic rate of malignant obstructive jaundice was analyzed by conventional ultrasound, venography and combined cholangiography. Results the diagnostic coincidence rates of conventional ultrasound, venography and combined cholangiography were 72.1% (31 / 43), 83.7% (36 / 43), 81.4% (35 / 43) and 93.0% (40 / 43), respectively. The diagnostic coincidence rate of combined choledochography was significantly better than that of conventional ultrasound (P0.021), but there was no significant difference between single venography or choledochography and conventional ultrasound (P0. 194,0.307). Conclusion: choledochography combined with venography can comprehensively evaluate the intra- and extraluminal bile duct obstruction, improve the diagnostic accuracy of ultrasonography for malignant obstructive jaundice, and effectively judge the resectability of the operation. It has good clinical value.
【作者单位】：解放军第八一医院普外科微创中心;解放军第八一医院超声科;
【基金】：全军医学科研基金科技攻关项目(编号:08G022)
【分类号】：R575

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