超声引导经皮肝穿刺置管对口引流治疗胆管空肠Roux-en-Y吻合术后肝脓肿
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汪涛, Email: watopo@163. com

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全军临床高新技术重大基金资助项目(2010gxjs040);四川省青年科技创新研究团队资助项目(2011JTD0010)。


Ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage for liver abscess after Roux-en-Y hepaticojejunostomy
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    摘要:

    目的:探讨超声引导经皮肝穿刺置管对口引流治疗胆管空肠Roux-en-Y吻合术后肝脓肿的临床效果。 方法:回顾性分析2012年1月—2014年1月接受超声引导经皮肝穿刺置管对口引流治疗胆管空肠Roux-en-Y吻合术后肝脓肿的20例患者的临床资料。 结果:20例患者均穿刺置管成功,置管后24~48 h疼痛症状缓解,48~72 h体温恢复正常,疼痛、寒战症状消失,72~96 h白细胞恢复到正常范围,且在持续引流过程中引流管未见堵管及引流不畅现象。带管时间为11 d至1个月,平均时间为14 d。20例患者均未出现出血、周围脏器损伤等严重并发症。 结论:超声引导经皮肝穿刺置管对口引流是治疗胆管空肠Roux-en-Y吻合术后肝脓肿可靠、有效的方法。

    Abstract:

    Objective: To evaluate the clinical efficacy of ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage for liver abscess after Roux-en-Y hepaticojejunostomy. Methods: The clinical data of 20 patients with liver abscess after Roux-en-Y hepaticojejunostomy undergoing ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage from January 2012 to January 2014 were retrospectively analyzed. Results: In all 20 patients, catheterization was successfully performed, the symptoms of pain were alleviated 24–48 h after catheterization, body temperature returned to normal, and the symptoms of pain and chills disappeared 48–72 h after catheterization; white blood cell levels returned to normal range 72–96 h after catheterization, and no tube blockage or partial blockage occurred during the continuous drainage. The tube retention time ranged from 11 d to one month, with an average of 14 d. No serious complications such as hemorrhage or surrounding organ injuries were noted in any of the 20 patients. Conclusion: Interventional ultrasound-guided percutaneous transhepatic catheterization and bidirectional drainage is a reliable and effective management for liver abscess after Roux-en-Y hepaticojejunostomy.

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张辉,陈光宇,陈琪,汪涛.超声引导经皮肝穿刺置管对口引流治疗胆管空肠Roux-en-Y吻合术后肝脓肿[J].中国普通外科杂志,2015,24(8):1150-1154.
DOI:10.3978/j. issn.1005-6947.2015.08.019

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  • 收稿日期:2015-01-08
  • 最后修改日期:2015-07-06
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  • 在线发布日期: 2015-08-15