摘要
目的:探讨DSA介入引导经皮肝穿刺胆道引流术(PTCD)联合胆道内支架治疗高危胆道恶性梗阻的临床效果。方法:筛选胆道恶性梗阻患者35例作为研究对象。所有患者采用DSA介入引导经皮肝穿刺胆道引流术联合胆道内支架进行治疗,比较术前与术后患者的血清胆红素等指标,并统计术后并发症发生情况。结果:35例患者一次性穿刺及支架置入成功,成功率为100.00%。试验室检验结果表明术后7 d、14 d与术前血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)指标比较,差异有统计学意义(P<0.05)。术后1个月内发生胆道感染2例(5.71%),急性胰腺炎3例(8.57%),支架脱落移位1例(2.86%),无胆汁性腹膜炎及其他并发症发生。结论:DSA介入引导经皮肝穿刺胆道引流术(PTCD)联合胆道内支架治疗高危胆道恶性梗阻可显著缓解黄疸症状,术后并发症发生率较低,较单纯超声定位模式具有穿刺准确的优势,临床治疗效果及应用价值值得肯定。
Objective To investigate the clinical results of DSA intervention guided percutaneous transhepatie biliary drainage （PTCD） combined with biliary stent in the treatment of the high risk of malignant biliary obstruction. Method To screen 35 cases of malignant biliar- y obstruction in patients as research subjects. All patients with DSA intervention guided percutaneous transhepatic biliary drainage combined with biliary stent for treatment, compared before preoperative and postoperative serum bilirubin and other indicators and statistical occur- rence of postoperative complications. Results 35 patients with disposable puncture and stent placement were successful, a success rate of 100. 00 percent ,laboratory test results showed that comparing with serum total bilirubin （TBIL）, direct bilirubin （ DBIL）, indirect bilirubin （IBIL） indicators after 7d, 14d and preoperative were significandy different （P 〈 0. 05 ） , biliary tract infection was 2 cases （5.71%） oc- curred within 1 month after surgery,acute panereatitis was three cases （8.57%） ,stand off shift was one case （2. 86% ） ,there was no bile peritonitis and other complications. Conclusion I）SA intervention guided pereutaneous transbepatic hiliary drainage （ PTCD ） combined with biliary stent in the treatment of the high risk of malignant biliary obstruction can significantly relieve symptoms of jaundice ,which is a lower incidence of postoperative complications ,than a simple ultrasound positioning mode has the advantage of puncture accurate ,the clini- cal treatment effect and value are worthy of recognition.
出处
《吉林医学》
CAS
2015年第4期609-610,共2页
Jilin Medical Journal
