文章摘要

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

作者: 1张辉, 1陈光宇, 1陈琪, 1汪涛
1 四川省成都军区总医院 普通外科微创中心,四川 成都 610083
通讯: 汪涛 Email: watopo@163.com
DOI: 10.3978/.10.3978/j.issn.1005-6947.2015.08.019
基金: 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

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。
关键词: 肝脓肿/ 超声检查 引流术 穿刺抽液术 手术后并发症

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

Authors: 1ZHANG Hui, 1CHEN Guangyu, 1CHEN Qi, 1WANG Tao
1 Center of Minimally Invasive Surgery, Department of General Surgery, General Hospital of Chengdu Military Region, Chengdu 610083, China

CorrespondingAuthor:WANG Tao Email: watopo@163.com

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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