摘要
目的 探讨肝胆系统非血管性介入放射学中并发症发生的原因、预防及其处理。材料与方法 45 3例行经导管碘油抗癌药乳化剂栓塞化疗 (TOCE)后的肝癌残余癌灶接受经皮无水乙醇注射治疗 (PEI) ,每次经 2 2F穿刺针注入无水乙醇 6～ 3 0ml,平均12ml。每周行PEI 1～ 2次 ,每例共行 3～ 2 0次 ,平均 6.5次。 2 2 1例阻塞性黄疸患者行经皮肝胆道穿刺引流 (PTBD) ,其中 48例引流 1～ 2天后行胆道支架置入术 (PTBS)。支架直径 10mm ,长度 4～ 8cm。 43例放置 1枚 ,5例放置 2枚。结果 PEI中的并发症包括胆管损伤 5例 ,占 1.1% ;乙醇碘油外溢 8例 ,占 1.8% ;肝功能衰竭 1例 ,占 0 .2 %。PTBD的并发症为肋间动脉损伤出血 1例 ,占 0 .5 % ;PTBS的并发症为肝脓肿 2例 ,占 4.2 %。结论 以上并发症的发生概率表明肝胆系统非血管性介入放射技术是安全的 ,通过发生原因的分析 ,其预防和处理是可以做到的。
Objective To elucidate the causes, precautions and management of complications occurred in nonvascular interventional procedures of hepatobiliary system.Materials and Methods Percutaneous ethanol injection (PEI) was performed in 453 cases for the residual foci of hepatocellular carcinoma after transcatheter oily chemoembolization (TOCE) therapy. Using 22F puncture needle, 6～30ml (mean 12ml) ethanol was injected each procedure, and once or twice every week. All patients received 3～20 times of treatment (mean 6.5 times). Percutaneous transhepatic biliary drainage (PTBD) was performed in 221 patients with obstructive jaundice. Among them 48 underwent percutaneous transhepatic biliary stenting (PTBS) at the 1 st or 2 nd day after PTBD, with the stent diameter of 10mm and length of 4～8cm. Forty three patients received one stent and 5 patients received two.Results Complications of PEI included injury of biliary ducts (n=5); fluxion of oil emulsion with ethanol (n=8); and hepatic failure (n=1). The complications of PTBD and PTBS were intercostal artery bleeding due to injury (n=1) and hepatic abscess formation (n=2), respectively.Conclusion Low occurrence of complications indicates that nonvascular interventional procedures of hepatobiliary system is a safe technique. Knowing the causes of the complications, effective prevention and management are possible.
出处
《临床放射学杂志》
CSCD
北大核心
2000年第4期205-207,共3页
Journal of Clinical Radiology
关键词
并发症
介入放射学
肝胆系统
Complication Radiology,interventional Hepatobiliary system
