超声造影在经皮经肝胆道引流术中的临床应用

目的 探讨超声造影在经皮经肝胆道引流术(PTCD)中的临床应用价值.方法 回顾性分析因阻黄行PTCD和超声造影37例,超声引导下穿刺胆道并置入引流管.将SonoVue溶液经穿刺针注入后,观察SonoVue微泡在胆系、肠道的流动和充填情况.所有病例均于术后2～12h行X线胆管泛影葡胺造影.结果 胆管超声造影(USC)和传统的经皮经肝胆管造影(PTC)在判断胆管梗阻程度、对肠道的显示(x2=0.5,0.50＞P＞0.25)及胆管分支级别(t =0.697,P＞0.25)方面差异无统计学意义；USC对胆囊的显示率低于PTC,差异有统计学意义(x2=7.11,0.01＞P＞0.005).结论 在超声引导PTCD术中,超声造影可以准确显示病变所在部位及管腔梗阻程度,实时观察引流管的有效引流范围指导手术方案的制定,为实现胆管最有效引流提供了可靠的保障.

Clinical study of contrast-enhanced ultrasound-guided percutaneous cholangiography and cholangiodrainage

Objective To discuss the clinical value of the ultrasonic cholangiography （USC） with contrast agent sonovue in ultrasound-guided percutaneous transhepatic cholangial drainage （UG-PTCD）. Methods 37 patients with obstructive jaundice were enrolled in this study. All the patients underwent ultrasound-guided PTCD. Afterwards, the contrast agent solution was administrated from the transfixion pin or drainage tube slowly. After postoperative 2 ~ 12 h, the PTC was carried out in each patient. Severity and accuracy of biliary obstruction were assessed according to the PTCUS findings with a comparison to conventional PTC. Results For PTCUS and PTC, there was no statistical significance in the judg- ment of bile ducts ＇ obstruction level, the display rate of intestinal tract （;（2 = 0.5, 0.50〉 P 〉0.25）and the maximum vi- sualization of branching orders （ t =0. 697, P 〉0.25）. PTCUS had a lower display rate in intestinal tract and gall bladder than PTC. The difference had statistics value （x2 = 7.11, 0.01〉 P 〉0. 005）. Conclusion PTCUS realized the carrying out of ultrasound-guided percutaneous transhepatic drainage and real-time ultrasonography in operation at the same time, offered more and accurate diagnosis information to operators. At last, the effectively drainage was to be realized.