c臂ct在经皮经肝胆道引流术治疗梗阻性黄疸中的应用

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1、介入放射学杂志2013年l2月第22卷第l2期JInterventRadiol2013．V0J．22．N0．12·非血管介入Non—vascularintervention·C臂CT在经皮经肝胆道引流术治疗梗阻性黄疸中的应用郑琳，郭晨阳，黎海亮，余朴，李亚楠【摘要】目的探讨C臂CT在经皮经肝胆道引流术(PTCD)治疗梗阻性黄疸中的应用。方法回顾性分析82例梗阻性黄疽患者，A组43例在C臂CT引导下PTCD治疗，B组39例在X线透视引导下PTCD治疗。研究终点是穿刺成功(自穿刺开始至安全地将导丝置入合

2、适的胆管内)。观察指标是穿刺次数、穿刺透视时间、总穿刺时间、辐射暴露剂量及并发症(胆道出血、胆汁性腹膜炎)的发生率。结果A组平均每例穿刺(1．1±0．3)次，显著少于B组的(2．8±0．6)次。A组穿刺透视时间为(13．1±2．7)s．穿刺时间为(46．9±9．7)s，均显著短于B组(33．7±6．2)s及(90．7±17．2)s。A组辐射暴露剂量(2．61±0．53)mGy也低于B组(6．75±1．23)mGy；B组有6例出现胆道出血。结论在FFCD治疗中，由C臂CT引导穿刺胆管较常规透视引导所需

3、穿刺次数及时间更少【关键词】梗阻性黄疸；C臂CT；穿刺；经皮经肝胆道置管引流：介人性中图分类号：R735．7文献标志码：A文章编号：1008．794X(2013)一12—1007—04TheapplicationofC—armCTinperformingPTCDforobstructivejaundiceZHENGLin，GUOChen—yang，LIHai—liang，YUPu，LIYa—nan．DepartmentofInterventionalRadiology，HenanProvincial

4、CancerHospital，theAffiliatedCancerHospitalofZhengzhouUniversity，Zhengzhou，HenanProvince450008，ChinaCorrespondingauthor：LIHai—liang，E—mail：cir．1ihailiang~ip．163．con【Abstract】ObjectiveTodiscusstheclinicalapplicationofC—arnlCTinperformingpercutaneoustrans

5、hepaticcholangiopancreaticdrainage(PTCD)forobstructivejaundice．MethodsTheclinicaldataof82patientswithobstructivejaundicewereretrospectivelyanalyzed．Thepatientsweredividedintostudygroup(n=43)andcontrolgroup(n=39)．C—armCTguidedPTCDwasperformedforpatients

6、ofthestudygroup，whileunderfluoroscopicguidancePTCDwascarriedoutforpatientsofthecontrolgroup．Theendpointofthestudywasthesuccessfulpuncture，i．e．asafeprocedurecoursefromthecorrectpuncturingtothesafeplacementofaguide—wireintoaproperbileduct．Thetimesofpunct

7、uring，thefluoroscopytimefortheprocedure，thetotalpuncturingtime，theexposureradiationdose，andtheoccurrenceofcomplicationssuchashemobilia，biliaryperitonitis，etc．wererecorded．Theresultswereanalyzed．ResultsThenumberofpuncturinginthestudygroupwas(1．1±0．3)tim

8、es，whileitwas(2．84-0．6)timesinthecontrolgroup，thedifferencebetweenthetwogroupswassignificant．Thefluoroscopytimeandthetotalpuncturingtimeofthestudygroupwere(13．1±2．7)secand(46．9±9．7)secrespectively，whilethoseofthecontrolgroupwere(33．74-6