CAJ | 학술논문

目的：探讨数字减影血管造影（digital subtraction angiography ，DSA）联合彩超引导经皮经肝胆管穿刺置管引流术（per-cutaneous transhepatic cholangial drainage ，PTCD）治疗恶性梗阻性黄疸的临床应用价值，以提高PTCD的穿刺成功率及内外引流率，减少并发症。方法：36例恶性梗阻性黄疸患者在彩超引导下穿刺进针，随后在DSA引导下推送导丝导管至目标区域，行内外引流。结果：36例患者的一次穿刺成功率为89％，两次穿刺成功率为100％；置内外引流管一次成功率为81％，总内外引流成功率为94％；均未发生严重并发症。结论：DSA联合彩超引导PTCD置管内外引流安全简便、成功率高，是治疗恶性梗阻性黄疸的较为理想的方法。
목적：탐토수자감영혈관조영（digital subtraction angiography ，DSA）연합채초인도경피경간담관천자치관인류술（per-cutaneous transhepatic cholangial drainage ，PTCD）치료악성경조성황달적림상응용개치，이제고PTCD적천자성공솔급내외인류솔，감소병발증。방법：36례악성경조성황달환자재채초인도하천자진침，수후재DSA인도하추송도사도관지목표구역，행내외인류。결과：36례환자적일차천자성공솔위89％，량차천자성공솔위100％；치내외인류관일차성공솔위81％，총내외인류성공솔위94％；균미발생엄중병발증。결론：DSA연합채초인도PTCD치관내외인류안전간편、성공솔고，시치료악성경조성황달적교위이상적방법。
Objective:To investigate the clinital value of percutaneous transhepatic cholangial drainage (PTCD) guided by dig-ital subtraction angiography(DSA) and color Doppler Ultrasonography in the treatment of patients with malignant obstructive jaundice so as to improve the success rate of PTCD puncture and internal and external drainage and reduce the complications . Methods :Thirty-six patients with malignant obstructive jaundice were punctured with the guidance of color Doppler ultrasonog-raphy .Then the wire and catheter were placed into the target area guided by DSA in order to perform the internal and external drainage .Results:The success rates of once and twice puncture were 89% and 100% ,respectively .The once success rate of internal and external drainage was 81% ,and the total success rate of internal and external drainage was 94% .No severe com-plication occurred .Conclusions :PTCD guided by DSA and color Doppler ultrasonography is an ideal method for internal and ex-ternal drainage in patients with malignant obstructive jaundice because of its safety ,simplicity and high success rate .