超声引导下鼻胆管引流的临床应用价值

目的探讨超声引导下内镜鼻胆管引流术（ENBD）的效果和临床应用价值。方法对术前经超声、CT或MRCP检查提示胆总管结石、胆总管扩张并肝吸虫感染，恶性梗阻性黄疸、急性胰腺炎、胆道狭窄共70例患者行超声引导下ENBD术、ERCP术，术后所有患者行X线下内镜逆行胆胰管造影（ERCP）进行对照。结果（1）本组所有病例均在超声引导下行ENBD术，与X线ERCP对照，符合率为100％。（2）超声能清晰地显示ERCP管并监测ERCP管进入胆总管的安放过程。（3）超声ERCP术可提高超声诊断率。结论超声引导下可行ENBD术，达到同样定位效果。且具有无辐射、无过敏，可进行床边急诊治疗等优点。

Clinical application of ultrasound guided endoscopic nasal biliary drainage

Objective To investigate the effectiveness and clinical value of ultrasound guided endoscopic nasal biliary drainage. Methods Endoscopic nasal biliary drainage （ENBD） guided by ultrasound was performed in seventy patients with common bile duct stone, dilation of common bile duct with liver trematode infection, obstructive jaundice caused by malignancy, acute pancreatitis and bile duct stricture. All the cases underwent ultrasound, CT or MRCP examination before ENBD. After these procedures, all the cases received X-ray-guided ERCP for comparision. Results （1） All patients accepted ENBD under ultrasound guidance, the agreement between ultrasound and ERCP was 100%. （2） Ultrasound could show and monitor the process of ERCP entering into the common bile duct clearly. （3） ERCP under ultrasound guidance could improve the diagnosis rate. Conclusion Ultrasound guidance can replace X-ray in ENBD, and achieve the same effect. Ultrasound guidance also has the virtues such as cost-effectiveness, no radiation, no allergic reaction and availability at bedside, thus it has great potential in clinical practice.