本文選題：惡性膽道梗阻　切入點(diǎn)：超聲檢查　出處：《中國(guó)介入影像與治療學(xué)》2017年06期 　論文類型：期刊論文

【摘要】：目的探討超聲引導(dǎo)下肝內(nèi)膽管穿刺聯(lián)合DSA膽道雙支架植入內(nèi)引流治療老年高位惡性膽道梗阻(MHBO)的臨床應(yīng)用價(jià)值。方法收集老年MHBO患者108例,超聲組54例在超聲引導(dǎo)下行肝內(nèi)膽管穿刺,DSA組54例在DSA下行肝內(nèi)膽管盲穿;2組患者穿刺成功后,于DSA下視情況行膽道雙支架植入內(nèi)引流、膽道單支架植入并對(duì)側(cè)外引流、膽道完全外引流及優(yōu)勢(shì)側(cè)膽道外引流;分析2組患者肝內(nèi)膽管穿刺、近期并發(fā)癥及4種膽道引流方式的療效。結(jié)果超聲組患者膽管穿刺次數(shù)、穿刺對(duì)比劑用量、膽道出血及穿刺點(diǎn)疼痛發(fā)生率明顯小于DSA組(P均0.05),1次穿刺成功率明顯高于DSA組(P0.05)。4種膽道引流方式術(shù)后第14天肝功能指標(biāo)及術(shù)后第21天總膽紅素(TBIL)值組間兩兩比較差異均有統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論超聲引導(dǎo)穿刺技術(shù)聯(lián)合DSA膽道雙支架植入內(nèi)引流治療老年MHBO有明顯的臨床實(shí)用價(jià)值。
[Abstract]:Objective to investigate the clinical value of ultrasound guided intrahepatic bile duct puncture combined with double stent drainage of DSA biliary tract in the treatment of high malignant biliary obstruction in the elderly. Methods 108 cases of elderly patients with MHBO were collected. After successful puncture of intrahepatic bile duct under DSA, 54 patients in the ultrasound group underwent double stent drainage under DSA, single stent implantation and contralateral external drainage. Total external drainage of biliary tract and external drainage of dominant side of bile duct were analyzed in two groups of patients with intrahepatic bile duct puncture, short-term complications and 4 kinds of biliary drainage methods. Results the times of bile duct puncture and the dosage of puncture contrast agent were analyzed in ultrasonic group. The incidence of biliary bleeding and pain at puncture point was significantly lower than that in DSA group (P < 0.05). The successful rate of puncture was significantly higher than that in DSA group on the 14th day after operation and the value of total bilirubin TBIL on the 21st day after operation. Conclusion Ultrasound-guided puncture combined with double-stent drainage of DSA biliary tract is of great clinical value in the treatment of elderly patients with MHBO.
【作者單位】： 河北醫(yī)科大學(xué)第四醫(yī)院放射科;
【分類號(hào)】：R445.1;R730.5
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本文編號(hào)：1559714