Objective To investigate the clinical application value of percutaneous transhepatic cholangial drainage ( PTCD) treatment in patients with obstructive jaundice under ultrasound guidance. Methods PTCD treatment was performed on 79 patients with obstructive jaundice suffering from malignant diseases under ultrasound guidance. The vital signs of the patients,peritoneal irritation sign and bleeding were observed, the bile flow was recorded, the change of total bilirubin was monitored 1 week after drainage. Results Seventy - seven patients were succeeded with the once success rate of 91. l％ , 5 cases were succeeded by choosing another pathway, 2 cases were failed. One week after PTCD, the total bilirubin was decreased significantly, general state of health was improved significantly. One case was complicated with bile peritonitis. 1 case was complicated little bleeding, no other severe complications happened. Conclusion PTCD under ultrasound guidance is a safe,simple and effective method for patients with obstructive jaundice.%目的 探讨超声引导经皮经肝穿刺胆管置管引流术(PTCD)治疗恶性肿瘤引起的阻塞性黄疸的临床应用价值.方法 对我院79例恶性肿瘤引起阻塞性黄疸的患者行超声引导PTCD治疗,术后观察患者生命体征、有无腹膜刺激征及出血症状,并记录胆汁引流量,监测置管后1周总胆红素的变化情况.结果 72例患者一次穿刺置管成功率达91.1%,5例经另选穿刺路径后置管成功,2例置管失败.77例置管引流患者与穿刺前相比,引流后l周总胆红素显著下降,一般情况明显改善.所有患者均无严重并发症发生,1例患者并发胆汁性腹膜炎,1例患者并发少量出血.结论 超声引导PTCD是一项姑息性治疗阻塞性黄疸的快捷、安全、有效且并发症较少的方法.
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