超声引导下PTCD在恶性梗阻性黄疸术前减黄的实用价值

本文对30例恶性梗阻性黄疸患者进行了分析,20例术前减黄组均采用超声引导下PTCD,减黄前血清胆红素平均13mg/dl,减黄到6mg/dl时施行手术。不减黄者血清胆红素平均为7.8mg/dl时施行手术。两组手术并发症和死亡率无显著差异。作者认为减黄组在13mg/dl时不减黄就怍切除术则术后并发症和死亡率会更高,因此主张术前减黄。超声具有无痛苦、无创伤,实时动态,移动方便等特点,即能降低并发症的发生率又可确保PTCD的顺利完成,PTCD应首选超声引导下,由技术熟练的外科医师实施。

Practical value of PTCD under ultrasonic detection to treat acute obstructive jaundice before operation

30 cases of acute obstructive jaundice were analysised, PTCD were operated in 20 cases to reduce jaundice under ultrasonic detection, while serum bilirubin were decreased from 13mg/dl to 6mg/dl. it is a proper time to give an operation. In control group, operation was done when mean level of serum bilirubin was 7. 8 mg/dl. The result showed that there was no significantly difference of postoperative complication and mortality in two groups. These suggest that operation is very dangerous, when serum bilirubin is 13 mg/ dl. The use of PTCD to care acute osbtructive jaundice as a routine before operation will improve clinical results, but it should operate by skillful surgeon. Ultrasonic detection also play an important role in operation.