恶性梗阻性黄疸介入治疗术后并发症分析及其防治.doc

恶性梗阻性黄疸介入治疗术后并发症分析及其防治
【摘要】目的探讨经皮肝穿刺胆管引流术和内支架置入术治疗恶性梗阻性黄疸并发症分析及防治。方法 35例恶性梗阻性黄疸患者接受经皮经肝胆管引流和置入内支架治疗。其中胰腺癌12例,转移性癌10例,肝门部肝癌9例,胆管癌4例。结果 26例放置了胆管支架,其中1例因左右肝总管梗阻各放置了1枚金属内支架;28例放置了内外引流管;7例单纯放置外引流管。与操作有关的并发症为胆管出血3例,无出血性休克病例;感染4例,1例出现败血症;肝功能损害8例;引流管部分移位或脱出7例,无腹腔内脱管;瘘口渗漏3例;电解质紊乱2例;胰腺炎1例;局限胆汁性腹膜炎并发反应性胸腔积液1例;引流管阻塞1例;支架置入后发生再狭窄1例。无气胸、肝脓肿等并发症。结论恶性梗阻性黄疸介入治疗方法简便、疗效确切,严格掌握适应证和禁忌症,规范操作技术可以减少并发症的发生。
【关键词】恶性梗阻性黄疸介入放射学并发症防治
【Abstract】 Objective: To investigate the methods and the prevention measures plications of percutaneous transhepatic biliary drainage and stent placement therapy for malignant obstructive : 35 patients received the percutaneous transhepatic biliary drainage and stent placement therapy for malignant obstructive jaundice, of which 12 of them suffered from pancreatic carcinoma, 10 of them suffered from metastatic carcinoma, 9 of them suffered from perihepatic hilar tumor and 4 of them suffered from : 26 of the patients were implanted biliary endoprothesis, of which 1 was implanted a metal biliary endoprothesis due to the left and right hepatic duct obstruction of the patient; 28 of the patients were inplanted internal-external drainage tube; 7 of the patients were implanted only the external drainage tube. plications involved were 3 cases of hemobilia, but no hemorrhagic shock; 4 cases of infection, of which one was septicemia; 8 cases of liver damage; 7 cases of drainage tube displacement and prolapse, but no intraperitoneal prolapse; 3 cases of fistula leakage; 2 cases of electrolytes disturbance; 1 case of pancreatitis; 1 case of limited reaction of bile peritonitis plicated pleural effusion; 1 case of drainage tube obstruction; 1 case of stenosis after stenting. No case plications such as pneumothorax or : The interventional therapy of malignant obstructive jaundice is simple, convenient and exact. By fully mastering the indications and contraindications, and standardizing the techniques of it,