摘要目的 探讨超声实时引导结合X线透视下,经皮肝胆管穿刺置管引流术(PTBD)治疗肝内胆管微扩张型梗阻性黄疸的操作技术及其临床应用价值.方法 回顾性分析9例肝内胆管微扩张型梗阻性黄疸患者的临床资料,6例行右肝胆管PTBD,3例行左肝胆管PTBD.结果 胆管穿刺置管成功率100%,术后短暂性发热1例、一过性血性胆汁1例,未出现腹腔出血及胆汁性腹膜炎等严重并发症,术后一周胆红素平均下降(75.4±29.6)μmol/L.引流时间10 d～5个月.结论 超声引导结合X线透视下PTBD治疗肝内胆管微扩张型梗阻性黄疸是安全可行的.

abstractsObjective To investigate the technical and clinical value of PTBD in patients with obstructive jaundice with nondilated intrahepatic bile ducts by the guiding of ultrasound combined with X-ray scan.Methods PTBD was performed in 9 patients with with nondilated intrahepatic bile ducts, guided by combining ultrasound and X-ray scan. 6 patients were punctured to right bile ducts and 3 were left bile ducts. Results Technical success was obtained in all patients. There were only two minor complications: transient hemobilia (n=1 ) and fever( n = 1 ). No hemorrhage and biliary peritonitis were found after procedures. The bilirubin was reduced by75.4 ± 29. 6ummol/L one week later. Conclusion Ultrasound-and-fluoroscopy guided PTBD in patients with nondilated bile ducts is a safe,feasible,and efficient procedure for the palliation of biliary obstruction.