超声导航技术辅助经皮穿刺胆管置管引流术治疗

目的:探讨超声导航技术辅助经皮穿刺胆管置管引流术治疗的临床效果。方法:选择收治的60例恶性梗阻性黄疸患者，划分为30例/组，两组均行经皮穿刺胆管置管引流术，对照组采取X线辅助，观察组采取超声导航技术辅助，比较两组的穿刺成功率、穿刺时间、穿刺次数、生命体征指标、疼痛评分、舒适度评分、并发症发生率、胆汁引流量、肝功能指标。结果:（1）统计首次穿刺和首二次穿刺的成功率，观察组均较对照组高（P<0.05）；（2）统计单次穿刺和总穿刺时间，观察组均较对照组短（P<0.05），其穿刺次数，观察组也较对照组少（P<0.05）；（3）对照组穿刺前与穿刺后的心率、血压等生命体征指标均发生明显改变（P<0.05），而观察组穿刺前与穿刺后的生命体征指标均未发生明显改变（P>0.05）；（4）穿刺时及穿刺后，观察组的疼痛评分均较对照组更低（P<0.05），其舒适度评分均较对照组更高（P<0.05）；（5）并发症总发生率分别为0%（观察组）、13.33%（对照组），观察组较对照组更低（P<0.05）；（6）术后第1天、第2天、第3天，观察组与对照组的胆汁引流量比较，差异无统计学意义（P>0.05）；（7）组内AST、ALT、TBIL等肝功能指标比较，两组手术后均较手术前降低（P<0.05）。结论:利用超声导航技术，完成经皮穿刺胆管置管引流术的实施，实现对恶性梗阻性黄疸患者的胆汁予以充分引流，改善肝功能，还可提高穿刺成功率，减少穿刺耗时和次数，减轻穿刺疼痛感，减少并发症的发生。

Therapeutic effect of percutaneous transhepatic biliary drainage combined with ultrasoundbased navigation technique

Objective To study the therapeutic effect of percutaneous transhepatic biliary drainage assisted by ultrasound-based navigation technique.Methods Sixty patients with malignant obstructive jaundice were divided into two groups,with 30 patients in each group.The patients in both groups were treated with percutaneous transhepatic biliary drainage.The treatment in control group was guided by X-ray,and that in observation group were assisted by ultrasound-based navigation technique.The success rate of puncture,puncture time,puncture times,vital signs,pain score,comfort score,incidence of complications,volume of biliary drainage and liver function indexes were compared between two groups.Results(1)The success rates of the first-puncture and the first second-puncture in observation group were higher than those in control group(P<0.05).(2)Compared with those in control group,the time required for single puncture and the total puncture in observation group were shorter(P<0.05),and the puncture times in observation group had lessened(P<0.05).(3)The vital signs such as heart rate and blood pressure in control group were significantly changed before and after puncture(P<0.05),but there was no significant change in the vital signs in observation group before and after puncture(P>0.05).(4)Compared with control group,observation group had lower pain score(P<0.05)and higher comfort score(P<0.05).(5)The overall incidence of complications in observation group was lower than that in control group(0%vs 13.33%,P<0.05).(6)No significant difference was found in the volume of biliary drainage between observation group and control group on the 1st,2nd and 3rd day after operation(P>0.05).(7)The liver function indexes such asAST,ALT,TBIL in the two groups were decreased after operation(P<0.05).Conclusion Percutaneous transhepatic biliary drainage combined with ultrasoundbased navigation technique can not only fully drain bile in patients with malignant obstructive jaundice,but also improve liver functions,increase the success rate of puncture,reduce puncture time and puncture times,relieve puncture pain,and reduce the incidence of complications.