超声结合X线透视下PTCD治疗阻塞性黄疸的探讨

目的探讨超声实时引导结合X线透视下经皮肝胆管穿刺置管引流术（PTCD）治疗阻塞性黄疸的操作技术及其临床应用价值。方法58例阻塞性黄疸患者，47例为恶性阻塞性病变，11例为良性阻塞性病变，在超声实时引导结合X线透视下行PTCD术，穿刺右叶胆管51例，穿刺左叶胆管7例，并常规造影。结果穿刺成功率100％，未出现出血及胆汁性腹膜炎等并发症，术后一周胆红素平均下降75．4umol／L。结论超声引导结合x线透视下PTCD是一种治疗阻塞性黄疸的有效方法，具有安全、简便、经济、并发症少的优点。

Approach to treatmant for obstructive jaundice of PTCD graded by combining ultrasound with X-ray scan

Objective To investigate the technical and clinical value of PTCD in patients with obstructive jaundice by the guiding of ultrasound combined with X-ray scan. Methods PTCD was performed in 58 patients with obstructive jaundice, with 47 patients malignant diseases and 11 patients benign diseases, guided by combining ultrasound and X-ray scan. 51 patients were punctured to right bile ducts and 7 cases were left bile ducts. Cholangiography was routinely used. Results Technical success was obtained in all patients. No bleeding and biliary peritonitis were found after procedures. The bilirubin was reduced by 75.4ummol/L one week after operation. Conclusion The technique of PTCD guided by combining ultrasound with X-ray scan was safe, simple, cost saving and less complications for obstructive jaundice.