经皮肝穿胆道引流围术期常见并发症的防治

目的探讨经皮肝穿胆道引流围术期常见并发症发生的原因、预防和治疗方法。方法241例恶性阻塞性黄疸患者，行经皮肝穿胆道引流术，单纯内外引流管置入123例，支架118例，其中置入2枚支架者21例。结果术中术后并发症94例，发生率为39．00％，分别为胆心综合征或胆心反射21例，胆道大出血12例，引流管堵塞34例，菌血症13例，胆汁异常分泌7例，引流管脱出异位致胆汁性腹膜炎4例，支架位置不佳3例。结论经皮肝穿胆道引流围术期常见并发症应以预防为主，规范操作减少并发症的发生，分析并发症产生的原因提高并发症的处理能力。

Prevention and treatment of perioperative common complications of percutaneous transhepatic biliary drainage

Objective To analyzed the causes, prevention and management of perioperative complications occurred in percutaneous transhepatic biliary drainage （PTBD）. Methods Two hundred and forty - one cases of malignant obstructive jaundice patients underwent percutaneous transhepatic biliary drainage, internal and external biliary drainage tubes were placed in 123 cases, 118 cases were placed stent, 21 cases were placed two stents. Results Intraoperative and postoperative complications occurred in 94 patients, the incidence ,ate was 39.00%. Gallbladder cardiac reflex or biliary - cardiac syndrome in 21 cases, biliary tract bleeding in 12 cases, drainage tube blocked in 34 cases, bacteremia in 13 cases, abnormal secretion of bile in 7 cases, caused by biliary drainage tube extrusion of ectopic peritonitis in 4 cases, poor stent location in 3 cases. Conclusions Perioperative complications of percu- taneous transhepatic biliary drainage should focus on prevention, operations have been standardized to reduce the incidence of complications, analyze the causes of complications increased complications in processing power.