CT，B超定位引导在经皮经肝穿刺胆道引流术中的应用价值
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| 时间：2009-02-26 21:53:13 来源： 作者： |
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Application of Computerized Tomography and Bultrasonotomography to Operation of Percutaneous Transhepatic Biliary Drainage
Fan Chenglin, Zhang Wei, Liu Xianjun, Zhang Yi
Department of Radiology, Sichuan Provincial Corps Hospital of Chinese People’s Armed Police Forces, Leshan 614000, China
Abstract： Objective To study the application of computerized tomography (CT) and Bultrasonotomography to percutaneous transhepatic biliary drainage (PTBD) operation.Methods According to the reasonable operative plan, operation was performed under the guidance of CT and Bultrasonotomography on the examining table with Carm.Results Of all the 148 canals for drainage purpose successfully established in the PTBD operations, 98 were successful in puncture under the guidance of CT localization, 26 were successful under the guidance of CT localization plus Bultrasonotomography, and 24 were successful under the guidance of Bultrasonotomography.Conclusion The appropriate application of CT and Bultrasonotomography to the operation of PTBD can obviously not only enhance its success rate but reduce the postoperative complications as well.
Key words： computerized tomography; Bultrasonotomography; percutaneous transheatic biliary drainage
胆道梗阻患者多因黄疸就诊，梗阻时间长短不一，肝、肾功都有不同程度损害。经皮经肝穿刺胆道引流术(PTBD)在解除胆道梗阻，减轻黄疸，改善肝功等方面疗效确切。特别是因胆道梗阻导致的肝功能严重损害不能手术者，术前行PTBD，能明显改善患者的全身情况，提高手术治疗的安全性，减少术后并发症的发生。我院自2000年5月开始开展PTBD以来，一直运用CT，B超定位引导，在C形臂下操作，大大提高了成功率、减少患者创伤和并发症，缩短了手术时间。现报告如下。
1 资料与方法
1.1 一般资料
经影像学检查证实的胆道梗阻患者138例，男87例，女51例，年龄28~85岁，平均58.3岁。其中肝门部梗阻44例，胆总管梗阻58例，胆胰管十二指肠连接区梗阻25例，肝移植术后吻合口狭窄2例，胆总管结石8例，胆道术后胆总管狭窄闭锁l例。其中良性梗阻均经手术证实，恶性梗阻中行PTBD术后手术治疗的有25例，包括肝门部胆管癌3例，胆囊癌侵犯肝门部胆管3例，胆总管癌5例，胰头癌3例，胆胰管十二指肠连接区癌11例。
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