X线引导下PTCD技术在基层医院治疗恶性梗阻性黄疸的临床应用研究
Clinical Application of X-Ray Guided PTCD in the Treatment of Malignant Obstructive Jaundice in Primary Hospitals

目的：通过开展X线引导下PTCD技术，可望改善基层医院恶性梗阻性黄疸患者的生活质量及延长生存期，从而减轻患者的痛苦以及减少患者因单纯为行PTCD赴上级医院就诊而带来的不便，产生较好的社会及经济效益。方法：采用X线引导下PTCD技术治疗53例梗阻性黄疸患者。结果：X线引导下PTCD术穿刺1次穿刺置管成功48例，经2次穿刺置管成功3例，失败3例，术后7天，患者术后血清总胆红素、直接胆红素、谷丙转氨酶、谷草转氨酶对比术前显著降低，具有统计学意义(均P < 0.01)。置管后出现发热畏寒者等胆道感染症状者有2例，置管后出现胆道出血者2例，对症治疗后均好转。结论：X线引导下PTCD技术在基层医院是一种安全、简便、可靠的治疗梗阻性黄疸的方法。
Objective: Through the development of X-ray guided PTCD technology, it is expected to improve the postnatal quality and prolong the survival period of patients with malignant obstructive jaundice in primary hospitals, so as to reduce the pain of patients and the inconvenience of patients who simply go to the higher hospital for PTCD, and produce better social and economic benefits. Methods: Treatment of 53 patients with obstructive jaundice by PTCD guided by X-ray. Results: In PTCD guided by X-ray, 48 cases were successfully punctured once, 3 cases were successfully punctured twice, and 3 cases were failed. After 7 days, the levels of serum total bilirubin, direct bilirubin, ala-nine aminotransferase and aspartate aminotransferase were significantly lower than those before operation (all P < 0.01). There were 2 cases of biliary tract infection symptoms such as fever and chills after catheterization, and 2 cases of biliary tract hemorrhage after catheterization, which were improved after symptomatic treatment. Conclusion: PTCD under X-ray guidance is a safe, simple and reliable method for the treatment of obstructive jaundice in primary hospitals.