【摘要】 目的探讨CT引导下一步法经皮肝穿刺胆管引流术的临床应用价值。方法对104例梗阻性黄疸患者行CT引导下一步法胆管引流术,采用上腹部CT扫描选定腹壁穿刺点和靶胆管,确定穿刺路径和穿刺深度,使用6F穿刺引流系统穿刺靶胆管近侧壁,以J型导丝辅助推送引流管。结果 104例患者中123例次经皮胆管引流术中,共尝试穿刺131次,穿刺引流成功率和临床有效率分别为100%(104/104)和97.12%(101/104);术中无严重并发症发生,轻微并发症包括一过性血性胆汁7例和少量肝被膜下血肿1例,术后前腹壁下引流管部分脱出6例。结论 CT引导下一步法经皮肝穿刺胆管引流术是一种安全、简便、有效的梗阻性黄疸处置方法,特别适用于急症和手术前过渡性治疗。更多还原

【Abstract】 Objective To assess the value of percutaneous biliary drainage under CT guidance with single step drainage set.Methods One hundred and four patients with obstructive jaundice underwent one-step percutaneous biliary drainages under CT guide.Based on the upper abdominal CT scan,the skin approach and target bile duct were selected,and the resultant puncture routine and depth were determined.The outer wall of the target duct was punctured with 6Fsingle step drainage set.The catheter was advanced over a J-type guide wire.Results Totally 123times of biliary drainages were performed in 104patients with 131times of attempts,the technical and clinical success rate was 100%(104/104)and 97.12%(101/104),respectively.No severe complication nor procedure-related death occurred.Minor complication included transient hemobilia in 7patients and minor subcapsular hematoma in 1patient.After operation,the catheters were found partially fallen off under frontal abdominal wall in 6patients.Conclusion One-step percutaneous biliary drainages under CT guide is a safe,simple and effective method for obstructive jaundice,especially suitable for emergency and preoperative temporary usage.更多还原