PTC与PTBD在恶性梗阻性黄疸诊断治疗上的应用

本文报告对肿瘤性黄疸病人行PTC86例,PTBD30例的临床体会。指出PTC方法简单、成功率高、合并症少。PTBD治疗梗阻黄疸作用分为术前减黄和姑息外引流两方面。尤其是不需X线设备,床旁体表定位下的PTBD17例,15例成功,更为简便、合并症少,对梗阻性黄疸有治疗价值。作者建议,对肿瘤性黄疸病人采用以下诊治步骤:B超→ERCP→床旁PTBD→经管造影,决定治疗方案为进一步手术治疗或永久带管外引流,提供有力依据。

The Use of PTC and PTBD in the Diagnosis and Treatment of Malignant Obstructive Jaundice

The clinical experiences with 86 cases of PTC and 30 cases of PTBD on selected patients with apparent malignant obstructive jaundice are reported. The authors pointed out that the advantages of PTC were easiness of manipulation, higher rate of success and paucity of complications. The therapeutic value of PTBD lies in relief of jaundice before surgery and institution of palliative external drainage of bile. The bed-side PTBD was performed in 17 patients and succeeded in 15. The following sequence of procedures are advisable for diagnostic purposes in patients suspicious of malignant obstructive jaundice, namely, B-ultrasound ERCP, bed-side PTBD and PTC.