目的 探讨超声引导下经皮经肝胆管引流(PTCD)治疗梗阻性黄疸的临床价值.方法 在超声引导下对32例恶性梗阻性黄疸患者行PTCD术治疗,术后观察生命体征、胆汁引流量、临床症状及置管后1周胆红素的变化情况,以及有无腹膜炎表现和出血症状.结果 32例患者置管成功30例,成功率为93.75%,2例置管失败.置管引流后临床症状明显改善,1周后胆红素明显下降.所有患者术中术后均无严重并发症.结论 超声引导下PTCD具有方法简便、安全、微创、痛苦少的特点,是治疗恶性肿瘤所致梗阻性黄疸的有效方法.%Objective To explore the clinical value of ultrasound-guided percutaneous transhepatic cholangial drainage( PTCD )for treating obstructive jaundice.Methods PTCD were operated under the ultrasound-guided on 32 patients with malignant obstructive jaundice.The vital signs, the bile flow, the clinical symptoms, the change of bilirubin were observed one week after drainage, meanwhile peritoneal irritation sign and bleeding were observed.Results 30 cases out of 32 were successful,and the success rate was 93.75％ ,only 2 cases were failed.The clinical symptoms were improved significantly after PTCD, and bilirubin was decreased significantly after one week.There was no severe complications in all of the patients.Conclusion PTCD under ultrasound guidance is an efficient treatment for obstructive jaundice resulted by malignant tumor, with the features of technique convenience, safety, minimal invasion, and less suffering.
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