超声引导下PTCD姑息治疗恶性梗阻性黄疸

目的探讨超声引导下经皮经肝穿刺胆管置管引流术（PTCD）对恶性梗阻性黄疸的临床应用价值。方法应用超声诊断仪对16例恶性梗阻性黄疸患者行PTCD。结果全部置管成功，一次进针14例（87．5％），二次进针2例（12．5％）。经引流后黄疸均明显减退，血清总胆红素明显下降，术前血清总胆红素228～518μmol／L，术后1周血清总胆红素在86—277μmol／L之间，平均下降198．6μmol／L。肝功能明显改善，有效地改善了症状。结论超声引导下经皮肝胆道置管引流术对于恶性梗阻性黄疸的患者是一种安全、创伤小、简便、实用的治疗措施，可以明显延长恶性梗阻洼黄疸患者的生存时间，提高生活质量，具有较好的临床价值。

Palliative Treatment of Malignant Obstructive Jaundice by Percutaneous Transhepatic Cholangio Drainage under Ultrasonic Guidance

Objective To investigate the clinical value of percutaneous transhepatic cholangio drainage （PTCD） guided by ultrasound in the treatment of malignant obstructive jaundice. Methods PTCD was performed in 16 patients with malignant obstructive jaundice. Results The total successful rate was 100% ,in which the rate was 87.5% for first session and 12.5% for second session. The jaundice and serum total bilirubin were significantly decreased after drainage （from 228 -518μmol/L to 86 -277 μmol/L,average 198.6 μmol/L）. Liver function and other symptoms were improved obviously. Conclusion The technique of PTCD under the guidance of ultrasound is a safe, simple and practical treatment for patients with malignant obstructive jaundice. It can significantly prolong the survival time of patients, and improve their quality of life.