论文部分内容阅读
近年来报道胆结石一些非手术方法如ESWL和MTBE对某些选择性胆结石病人有令人鼓舞的效果,且较安全。作者等采用ESWL-MTEB序贯疗法来治疗一些不宜手术的部份钙化胆固醇结石患者。本研究目的是评估胆囊在经受ESWL创伤后是否易被MTBE损伤或引起MTBE过分吸收。材料和方法:8例病人(4男、4女,45～89岁)均符合下列要求:(a)有1～4颗结石,直径≥1.3 cm,结石成份以胆固醇为主;(b)胆囊管通畅;(c)术前健康状况符合手术指征;(d)无心律失常,未装心脏起搏器,无凝血障碍、急性胰腺炎、胆囊炎或妊娠。8例患者均使用Dornier HM_3肾碎石术机进行ESWL和MTBE联合治疗。病人使用2天Iopanoic acid后,在荧光屏指引下将一根70 cm长5 F(1.7 mm)的猪尾导管经皮置入胆囊,随后即进行碎石,震波在全麻和快速喷射换气下进行。通过胆囊导管滴注不透X线的造影剂,在交叉
Gallstones reported in recent years Some non-surgical methods such as ESWL and MTBE have encouraging results for some patients with selective gallstones and are safer. The authors used ESWL-MTEB sequential therapy to treat some patients with calcific cholesterol stones that are not suitable for surgery. The purpose of this study was to assess whether gallbladder is vulnerable to MTBE or leading to over-absorption of MTBE after ESGL trauma. MATERIALS AND METHODS: Eight patients (4 males and 4 females, 45-89 years old) all met the following requirements: (a) 1 to 4 stones with a diameter of 1.3 cm or more and cholesterol content in the stones; (b) Patency; (c) preoperative health meets surgical indications; (d) no arrhythmia, no pacemaker, no coagulopathy, acute pancreatitis, cholecystitis or pregnancy. All 8 patients underwent ESWL and MTBE combined with Dornier HM 3 nephrolithotomy. After 2 days of exposure to Iopanoic acid, a 70 cm long 5 F (1.7 mm) pigtail catheter was percutaneously placed in the gallbladder with subsequent screen guidance followed by lithotripsy under general anesthesia and rapid jet ventilation . Drip through the gallbladder catheter with radiopaque contrast agent at the cross