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目的总结急性化脓性胆管炎患者微创介入治疗的效果。方法对解放军总医院2001年6月至2005年6月收治的急性化脓性胆管炎经微创介入治疗的28例患者的临床资料进行回顾性分析。结果行单纯内镜下逆行胰胆管造影(ERCP)22例,其中乳头切开同时进行鼻胆管引流或取石者13例,胆管支架内引流者9例,在胆管支架内引流者中病变位于肝门下者5例,肝门上者4例,以肝门下梗阻引流效果好,肝门上肿瘤引流后症状缓解,术后患者高热消失,体温恢复正常;内镜下治疗联合经皮经肝胆管外引流术(PTCD)4例,全部治愈;单纯PTCD治疗2例,缓解1例,治愈1例。所有患者均未发生严重并发症。结论ERCP、PTCD和内镜下治疗联合PTCD方法治疗胆系化脓性炎症,创伤小、效果好,值得推广。
Objective To summarize the effect of minimally invasive interventional therapy in acute suppurative cholangitis. Methods The clinical data of 28 patients who underwent minimally invasive interventional treatment of acute suppurative cholangitis admitted to PLA General Hospital from June 2001 to June 2005 were retrospectively analyzed. Results Endoscopic retrograde cholangiopancreatography (ERCP) were performed in 22 cases, of which 13 cases were treated by papillary incision and drainage of nasal bile duct or stone, and 9 cases were treated with biliary stent drainage. In 5 cases, 4 cases of the hilar, in order to drain the effect of obstruction of the inferior hilar, tumor relief on the hilar tumor, hyperthermia disappeared after the operation, body temperature returned to normal; endoscopic treatment of percutaneous transhepatic biliary drainage (PTCD) in 4 cases, all cured; PTCD treatment in 2 cases, 1 case of remission, 1 case cured. No serious complications occurred in all patients. Conclusion ERCP, PTCD and endoscopic treatment combined with PTCD treatment of biliary purulent inflammation, trauma, good effect, it is worth promoting.