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[经皮经肝使用甲基叔丁基醚溶解胆结石。15例患者的报告]

[Percutaneous transhepatic lysis of gallstones using methyl tert-butyl ether. Report on 15 patients].

作者信息

Hellstern A, Leuschner M, Fischer H, Lazarovici D, Güldütuna S, Kurtz W, Leuschner U

机构信息

Zentrum der Inneren Medizin, Klinikum der Universität Frankfurt/Main.

出版信息

Dtsch Med Wochenschr. 1988 Mar 31;113(13):506-10. doi: 10.1055/s-2008-1067672.

Abstract

In 15 patients (13 women and two men) with cholesterol stones in the gall-bladder a special (Thistle) catheter was introduced into the gall-bladder under local anaesthesia by percutaneous transhepatic puncture. Methyl-tert-butyl ether, 2-15 ml, was injected via the catheter and removed again after 2 min. The number of stones per gall-bladder averaged 6.3 (1-20), size of stones 1.7 cm (0.5-2.8 cm), and duration of treatment 11.9 h (5-24 h). The stones dissolved in 13 patients (87%). In three patients stone débris remained: in one it was ultimately sucked out after reduction of the amount of débris with an EDTA-containing solution. The side effects of treatment--nausea and vomiting--were minor. In one patient there was a leak of bile from the gall-bladder after the procedure; a cholecystectomy was uneventfully performed. Another patient developed haemobilia which responded to conservative treatment. MTBE treatment has thus proved to be a successful and cheap method, low in side effects, in the treatment of patients with gall-stones.

摘要

对15例胆囊胆固醇结石患者(13例女性,2例男性)在局部麻醉下经皮经肝穿刺将特制的(蓟花)导管插入胆囊。通过导管注入2 - 15毫升甲基叔丁基醚,2分钟后再抽出。每个胆囊结石数量平均为6.3颗(1 - 20颗),结石大小为1.7厘米(0.5 - 2.8厘米),治疗时间为11.9小时(5 - 24小时)。13例患者(87%)的结石溶解。3例患者有结石残渣残留:1例在用含乙二胺四乙酸的溶液减少残渣量后最终被吸出。治疗的副作用——恶心和呕吐——较轻微。1例患者术后胆囊出现胆汁渗漏;顺利进行了胆囊切除术。另1例患者发生胆道出血,经保守治疗后好转。因此,甲基叔丁基醚治疗已被证明是一种治疗胆结石患者的成功且廉价的方法,副作用小。

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