Clinical study on the simple X-ray guided and combined with ultrasound guided PTCD in the interventional treatment of obstructive jaundice

Objective:To explore the clinical value of X-ray guided combined with ultrasound guided percutaneous biliary drainage(PTCD) in the interventional treatment of obstructive jaundice.Methods:Forty patients with obstructive jaundice were randomly divided into the pure X-ray guidance group(X-ray group) and X-ray combined with ultrasound guidance group(combined ultrasound group) using random number method(20 cases each group).The successful rate of one-time puncture,number of puncture,use of contrast agent,time of fluoroscopy and time of operation were recorded in two groups,the levels of total bilirubin(TBIL),direct bilirubin(DBIL),aspartate aminotransferase(AST) and alanine aminotransferase(ALT) in two groups were detected,and the incidence rate of postoperative complications in two groups were observed and counted.Results:The success rate of one-time puncture in combined ultrasound group was significantly higher than that in X-ray group(P<0.05).The average puncture times,use of contrast agent,time of fluoroscopy and time of operation in combined ultrasound group were significantly less than those in X-ray group(P<0.01).The serum biochemical indexes(such as TBIL,DBIL,AST and ALT) in two groups after operation were significantly improved compared with those before operation(P<0.05 to P<0.01),but there was no statistical significance in the TBIL in two groups between before and after operation(P>0.05),and the differences of biochemical indexes in two groups after operation were not statistically significant(P>0.05).The incidence rate of postoperative complications in combined ultrasound group was significantly lower than that in X-ray group(P<0.05).Conclusions:Simple X-ray guided and combined ultrasound guided PTCD intervention in the treatment of obstructive jaundice have a better effect on reducing yellowing,but compared with simple X-ray guidance,the value of combined ultrsound guidance is more prominent,which is worthy of clinical application.