摘要
目的:探讨单纯X线引导与联合超声定位导向经皮肝胆管引流术(PTCD)在介入治疗梗阻性黄疸中临床应用价值。方法:选取40例梗阻性黄疸病人作为研究对象,采用随机数字表法将入选病例分为单纯X线引导(X线组)和X线联合超声定位导向组(联合超声组),各20例,记录2组1次穿刺成功率、穿刺次数、对比剂使用量、透视时间、手术时间等相关手术指标,测定2组病人术前术后的总胆红素(TBIL)、直接胆红素(DBIL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)等血清生化指标,观察并统计2组术后并发症发生情况。结果:联合超声组1次穿刺成功率较X线组明显提高(P<0.05),联合超声组平均穿刺次数、对比剂使用量、透视时间、手术时间均较X线组明显缩短(P<0.01);2组病人术后DBIL、AST、ALT等血清生化指标均较术前明显改善(P<0.05~P<0.01);2组TBIL手术前后比较差异无统计学意义(P>0.05);术后2组血清生化指标差异均无统计学意义(P>0.05)。联合超声组术后并发症发生率明显低于X线组(P<0.05)。结论:单纯X线引导与联合超声定位导向PTCD介入治疗梗阻性黄疸均能起到较好的减黄效果,但相对单纯X线引导,联合超声定位导向应用价值更为突出,值得临床推广应用。
Objective： To explore the clinical value of X-ray guided combined with ultrasound guided percutaneous biliary drainage（ PTCD） in the interventional treatment of obstructive jaundice. Methods： Forty patients with obstructive jaundice were randomly divided into the pure X-ray guidance group（ X-ray group） and X-ray combined with ultrasound guidance group（ combined ultrasound group） using random number method（ 20 cases each group）. The successful rate of one-time puncture,number of puncture,use of contrast agent,time of fluoroscopy and time of operation were recorded in two groups,the levels of total bilirubin（ TBIL）,direct bilirubin（ DBIL）,aspartate aminotransferase（ AST） and alanine aminotransferase（ ALT） in two groups were detected,and the incidence rate of postoperative complications in two groups were observed and counted. Results： The success rate of one-time puncture in combined ultrasound group was significantly higher than that in X-ray group（ P〈0. 05）. The average puncture times,use of contrast agent,time of fluoroscopy and time of operation in combined ultrasound group were significantly less than those in X-ray group（ P〈0. 01）. The serum biochemical indexes（ such as TBIL,DBIL,AST and ALT） in two groups after operation were significantly improved compared with those before operation（ P〈0. 05 to P〈0. 01）,but there was no statistical significance in the TBIL in two groups between before and after operation（ P〉0. 05）,and the differences of biochemical indexes in two groups after operation were not statistically significant（ P〉0. 05）. The incidence rate of postoperative complications in combined ultrasound group was significantly lower than that in X-ray group（ P〈0. 05）. Conclusions： Simple X-ray guided and combined ultrasound guided PTCD intervention in the treatment of obstructive jaundice have a better effect on reducing yellowing,but compared with simple X-ray guidance,the value of combined ultrsound guidance is more prominent,which is worthy of clinical application.
作者
朱玉胜
黄太满
田德名
龙昊
ZHU Yu-sheng;HUANG Tai-man;TIAN De-ruing;LONG Hao(Ma＇anshan Shiqiye Hospital,Ma＇anshan Anhui 243000,China)
出处
《蚌埠医学院学报》
CAS
2018年第8期1076-1079,共4页
Journal of Bengbu Medical College
