超声引导下PTCD对恶性肝脏囊性病变的预后影响及治疗安全性分析(1)
【摘要】 目的：分析超声引导下PTCD(经皮经肝穿刺胆管置管引流)对恶性肝脏囊性病变患者预后及治疗安全性的影响。方法：选取本院2011年1月-2014年1月收治的30例恶性囊性病变患者作为研究对象，所有患者均给予经皮肝穿刺胆管置管引流治疗，观察其治疗效果及术后并发症发生率，统计首次穿刺置管成功率。结果：25例单发肝脏囊性病变患者，首次成功穿刺23例，成功率为92.00%，二次全部穿刺成功，二次成功率为100%，其PTCD首次置管成功率为88.00%；5例多发囊性病变者首次穿刺与置管成功率均为80.00%。随访结果提示，单发组临床控制9例，显效11例，好转2例，总有效率为88.00%；多发者，临床控制1例，显效2例，好转1例，总有效率为80.00%。结论：在恶性肝脏囊性病变患者的临床治疗中，应用超声引导下PTCD方案，有其较高的治疗效率，预后较好，术后并发症发生率低，安全性较高。
【关键词】 恶性肝脏囊性病变； 穿刺引流； 预后； 安全性
【Abstract】 Objective： To analyze the application of ultrasound guided PTCD (percutaneous transhepatic biliary drainage) effects on malignant cystic lesions in the liver treatment and the prognosis of patient safety. Method： 30 patients with malignant cystic lesion were selected in our hospital from January 2011 to January 2014 as study objects， all the patients were treated by percutaneous transhepatic biliary drainage treatment， to observe the therapeutic effects and the incidence of postoperative complications， statistics for the first time puncture success rate. Result： 25 patients with single cystic lesions in the liver， the first successful puncture in 23 cases， the success rate was 92.00%， all success in two times puncture， the success rate was 100%， the PTCD for the first time， the success rate of catheterization was 88.00%； 5 cases with multiple cystic lesions were the first successful puncture and catheterization rate was 80.00%. The follow-up results suggested that single clinical control group of 9 cases， 11 cases markedly effective， 2 cases improved， the total effective rate was 88.00%； multiple， 1 case of clinical control， 2 cases were cured， 1 case improved， the total effective rate was 80.00%. Conclusion： The clinical treatment of patients with malignant liver cystic lesions， guided PTCD scheme using ultrasound， with its high efficiency of treatment， the prognosis is good， the low incidence of postoperative complications and higher security.
, 百拇医药
【Key words】 Liver malignant cystic lesions； Puncture drainage； Prognosis； Safety
First-author’s address： Chinese Traditional Medical Hospital in Shenzhen， Shenzhen 518033， China
doi：10.3969/j.issn.1674-4985.2015.25.045
恶性肝脏囊性病变的产生与胆管异位存在一定的相关性，起源于肝内迷走胆管[1]。有文献提示，肝囊肿生长相对缓慢，大部分患者无明显症状表现，合并感染者可能出现发热、腹部疼痛、畏寒等症状[2]。针对肝脏囊性病变的传统治疗主要采取手术方案，包括囊肿切除术与开窗引流两种方式，但有文献提示，行囊肿切除术预后较差，甚至可能导致患者术后残疾，恢复时间慢，复发率较高[3]。也有报道显示，在恶性肝脏囊性病变患者的临床治疗中，应用超声引导下经皮肝胆穿刺置管引流方案，不仅操作便捷，给患者带来的痛苦少，同时有其感染率低、并发症发生少的优势，但对优化引流质量、提高穿刺置管成功率的探究依然是临床领域研究的重点课题。基于此，为进一步证实超声引导下PTCD在恶性肝脏囊性病变患者中的应用效果，背面院对近年来收治的30例患者进行了探究性研究，现报告如下。, 百拇医药(端学军等)
【关键词】 恶性肝脏囊性病变； 穿刺引流； 预后； 安全性
【Abstract】 Objective： To analyze the application of ultrasound guided PTCD (percutaneous transhepatic biliary drainage) effects on malignant cystic lesions in the liver treatment and the prognosis of patient safety. Method： 30 patients with malignant cystic lesion were selected in our hospital from January 2011 to January 2014 as study objects， all the patients were treated by percutaneous transhepatic biliary drainage treatment， to observe the therapeutic effects and the incidence of postoperative complications， statistics for the first time puncture success rate. Result： 25 patients with single cystic lesions in the liver， the first successful puncture in 23 cases， the success rate was 92.00%， all success in two times puncture， the success rate was 100%， the PTCD for the first time， the success rate of catheterization was 88.00%； 5 cases with multiple cystic lesions were the first successful puncture and catheterization rate was 80.00%. The follow-up results suggested that single clinical control group of 9 cases， 11 cases markedly effective， 2 cases improved， the total effective rate was 88.00%； multiple， 1 case of clinical control， 2 cases were cured， 1 case improved， the total effective rate was 80.00%. Conclusion： The clinical treatment of patients with malignant liver cystic lesions， guided PTCD scheme using ultrasound， with its high efficiency of treatment， the prognosis is good， the low incidence of postoperative complications and higher security.
, 百拇医药
【Key words】 Liver malignant cystic lesions； Puncture drainage； Prognosis； Safety
First-author’s address： Chinese Traditional Medical Hospital in Shenzhen， Shenzhen 518033， China
doi：10.3969/j.issn.1674-4985.2015.25.045
恶性肝脏囊性病变的产生与胆管异位存在一定的相关性，起源于肝内迷走胆管[1]。有文献提示，肝囊肿生长相对缓慢，大部分患者无明显症状表现，合并感染者可能出现发热、腹部疼痛、畏寒等症状[2]。针对肝脏囊性病变的传统治疗主要采取手术方案，包括囊肿切除术与开窗引流两种方式，但有文献提示，行囊肿切除术预后较差，甚至可能导致患者术后残疾，恢复时间慢，复发率较高[3]。也有报道显示，在恶性肝脏囊性病变患者的临床治疗中，应用超声引导下经皮肝胆穿刺置管引流方案，不仅操作便捷，给患者带来的痛苦少，同时有其感染率低、并发症发生少的优势，但对优化引流质量、提高穿刺置管成功率的探究依然是临床领域研究的重点课题。基于此，为进一步证实超声引导下PTCD在恶性肝脏囊性病变患者中的应用效果，背面院对近年来收治的30例患者进行了探究性研究，现报告如下。, 百拇医药(端学军等)