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目的探讨使用自行增加侧孔的引流管治疗高位梗阻性黄疸的临床价值。方法选择高位梗阻性黄疸患者27例,其中肝门部胆管癌19例,肝转移癌8例。经皮穿刺肝内胆管成功后,通过导丝导管测量所需附加侧孔位置,为引流管增加侧孔后引入胆管内,使新制作的侧孔位于梗阻平面以上,达到内外引流的目的 ,增强经皮胆道引流的疗效。结果 27例患者成功进行了自行增加侧孔引流管的植入,新增侧孔均位于梗阻平面以上,其中猪尾型头端位于胆总管者23例,位于左叶胆管者4例。18例术后总胆红素1周内下降至100μmol/L以下,9例下降至200μmol/L以下,临床有效率100.0%。结论使用自行增加侧孔的引流管治疗高位梗阻性黄疸方便、有效,近期疗效显著,有较高的临床价值。
Objective To explore the clinical value of using a self-expanding drainage tube to treat high obstructive jaundice. Methods 27 patients with high obstructive jaundice, including 19 cases of hilar cholangiocarcinoma and 8 cases of liver metastasis. Percutaneous puncture of the intrahepatic bile duct after successful, through the guide wire catheter to measure the location of the additional side hole required for the drainage tube side hole after the introduction of bile duct, the new hole in the obstruction plane above the plane, to achieve the purpose of internal and external drainage, enhanced Percutaneous biliary drainage effect. Results Twenty-seven patients underwent successful self-implantation of side-hole drainage tubes. The newly-added lateral holes were located above the obstruction level. Among them, 23 were pig-head end in the common bile duct and 4 were located in the left bile duct. 18 cases of total bilirubin within 1 week decreased to 100μmol / L or less, 9 cases decreased to 200μmol / L or less, the clinical efficiency of 100.0%. Conclusions It is convenient and effective to treat high obstructive jaundice by using self-expanding lateral drainage tube. It has significant short-term curative effect and high clinical value.