床旁便携式超声在经皮肝穿刺胆管支架置入术中应用

目的探讨床旁便携式超声在经皮肝穿刺胆管支架置入术中的应用价值。方法78例胆管恶性梗阻患者依据就诊时间分为2组，2006年1月--2009年8月人院31例为x线引导组，在X线引导下行经皮肝穿刺胆管支架置人术；2009年9月--2011年2月人院47例为超声引导组，在床旁便携式超声引导下行经皮肝穿刺胆管支架置入术，比较2组穿刺时间、一次穿刺成功率、术中及术后并发症发生率。结果x线引导组穿刺时间（305±109）s，一次穿刺成功率为6．45％，术中并发症发生率为16．10％，术后7d并发症发生率为22．60％；超声引导组穿刺时间（67±29）S，一次穿刺成功率为82．98％，术后7d并发症发生率为4．26％，未发生术中并发症，2组比较差异均有统计学意义（P〈O．05）；术后6个月2组均未出现并发症。结论床旁便携式超声引导下行经皮肝穿刺胆管支架置人术可缩短穿刺时间，提高穿刺成功率，降低并发症发生率。

Application of bedside ultrasound in percutaneous transhepatic insertion of biliary stent

Objective To investigate the value of bedside ultrasound to percutaneous transhepatic insertion of biliary stent. Methods Seventy-eight patients with malignant biliary obstruction were divided into two groups according to the admission time. The patients admitted from January 2006 to August 2009 received X-ray guided percutaneous transhepatic insertion of biliary stent （X-ray group, n= 31）, and those admitted from September 2009 to February 2011 received ultrasound guided percutaneous transhepatic insertion of biliary stent （ultrasound group, n = 47）. The puncture time, success rate of once puncture, and incidences of intraoperative and postoperative complications were compared between two groups. Results The puncture time, success rate of once puncture, incidence of intraoperative complications and the incidence of complication 7 days after operation were （305±109）s, 6.45%, 16. 10% and 22.60% in X-ray group, and （67±29）s, 82.98% and 4.26% in ultrasound group, showing significant differences between two groups （P〈0.05）. No complications occurred after 6 months. Conclusions Bedside ultrasound-guided percutaneous transhepatic insertion of biliary stent can shorten the operation time, improve success rate of puncture and reduce complications.