超声引导经皮经肝穿刺胆管引流术的临床应用

目的：探讨超声引导经皮经肝穿刺胆管置管引流（PTCD）的临床应用价值。方法：梗阻性黄疸32例，在超声引导下作经皮经肝胆管置管引流（PTCD）；对于超声显示导管不佳或位置不易确定，肝外胆道显示较差者，再在X线透视下作胆管造影术（PTC）行PTCD。结果：超声引导经皮经肝穿刺胆管1次性成功率达81．3％，2次性成功率达93．8％，3次性成功率达100％；单独超声引导下行PTCD术成功率达87．5％；超声引导结合PTC行PTCD术成功率达96．9％。结论：超声引导下经皮经肝穿刺胆管准确性高；PTCD术应首选超声引导；超声引导结合PTC可提高PTCD的成功率。

Clinical Application of Ultrasound-guided Percutaneous Transhepatic Cholangial Drainage

Objective:To study the clinical value of the US-guide to PTCD.Methods:PTCD were operated under the US-guide in thirty-two patients with obstructive jaundice.PTCD will be operated under the X-ray PTC guide for the patient whose duct was not easily seen to decide its position.Results:The successive rate of single puncture is very high,up to 81.3%,the rate of two-times puncture is 93.8%,and that of three-times puncture is 100% in the US-guided operation;The successive rate of the unitary US-guided PTCD reached to 87.5%;The rate of the integration of the US-guide with the PTC-guide is 96.9%.Conclusions:The accuracy of the US-guided percutandous transhepatic bile duct puncture is very high.Ultrasonography shoud be the first choice to guide PTCD operation.The US-guide combined with the PTC-guide can increase the successful rate of PTCD.