Objective To investigate the application value of ultrasound guidance combined with X-ray fluoroscopy for percutaneous transhepatic biliary drainage(PTBD).Methods A total of 157 patients with obstructive jaundice who underwent PTBD were selected and then divided into a control group(75 cases)and an observation group(82 cases)according to different guidance methods.The control group underwent puncture and catheterization of the biliary system under the guidance of traditional X-ray fluoroscopy.Meanwhile,the observation group underwent the puncture to the biliary system under ultrasound guidance and the catheterization under X-ray fluoroscopy.The success rates of puncture,operation and initial needle puncture,puncture times,operation time,X-ray fluoroscopy time,radiation dose and complication rate were compared between the two groups.Results Puncture and catheterization were successful in both groups,and the success rates of puncture and operation were all 100％.In the observation group,the success rate of initial needle puncture was 90.24％(74/82),which was higher than 74.67％(56/75)in the control group;the mean puncture times was 1.14,which was less than 1.77 in the control group;the mean operation time was 30.02 min,which was less than 40.09 min in the control group;the mean X-ray fluoroscopy time was 4.03 min,which was less than 6.61 min in the control group;the mean radiation dose was 49.08 mGy,which was less than 82.29 mGy in the control group,and all the differences above between the two groups were statistically significant(P＜0.05).In the observation group,there were 2 cases with biliary hemorrhage,3 cases with biliary infection,and 5 cases with biliary fistula(including 2 cases of secondary biliary peritonitis);while the control group had 10 cases with biliary hemorrhage,15 cases with biliary infection,13 cases with biliary fistula and 9 cases with biliary peritonitis,and the differences between the two groups were statistically significant(P＜0.05).Conclusion Ultrasound guidance combined with X-ray fluoroscopy for PTBD is safe and effective,with significantly short operation time,low radiation dose and fewer complications,which has a certain popularity value in different level hospitals.

Objective To investigate the application value of ultrasound guidance combined with X-ray fluoroscopy for percutaneous transhepatic biliary drainage(PTBD).Methods A total of 157 patients with obstructive jaundice who underwent PTBD were selected and then divided into a control group(75 cases)and an observation group(82 cases)according to different guidance methods.The control group underwent puncture and catheterization of the biliary system under the guidance of traditional X-ray fluoroscopy.Meanwhile,the observation group underwent the puncture to the biliary system under ultrasound guidance and the catheterization under X-ray fluoroscopy.The success rates of puncture,operation and initial needle puncture,puncture times,operation time,X-ray fluoroscopy time,radiation dose and complication rate were compared between the two groups.Results Puncture and catheterization were successful in both groups,and the success rates of puncture and operation were all 100％.In the observation group,the success rate of initial needle puncture was 90.24％(74/82),which was higher than 74.67％(56/75)in the control group;the mean puncture times was 1.14,which was less than 1.77 in the control group;the mean operation time was 30.02 min,which was less than 40.09 min in the control group;the mean X-ray fluoroscopy time was 4.03 min,which was less than 6.61 min in the control group;the mean radiation dose was 49.08 mGy,which was less than 82.29 mGy in the control group,and all the differences above between the two groups were statistically significant(P＜0.05).In the observation group,there were 2 cases with biliary hemorrhage,3 cases with biliary infection,and 5 cases with biliary fistula(including 2 cases of secondary biliary peritonitis);while the control group had 10 cases with biliary hemorrhage,15 cases with biliary infection,13 cases with biliary fistula and 9 cases with biliary peritonitis,and the differences between the two groups were statistically significant(P＜0.05).Conclusion Ultrasound guidance combined with X-ray fluoroscopy for PTBD is safe and effective,with significantly short operation time,low radiation dose and fewer complications,which has a certain popularity value in different level hospitals.

Objective:To evaluate the clinical efficacy of individualized thrombolysis-assisted comprehensive intervention for deep vein thrombosis (DVT) in the lower limbs.Methods:This study included 32 patients with acute lower limb DVT diagnosed by angiography who received treatment at the Jianhu Clinical Medical College of Yangzhou University from March 2012 to November 2021. These patients first received implantation of an inferior vena cava filter. Then they were divided into a control group and an observation group based on treatment methods. The control group received thrombolytic catheterization and a routine infusion of urokinase. In the observation group, balloon dilation was performed first, and a large lumen catheter was used to draw blood clots. Subsequently, urokinase at a dose based on fibrinogen measurement was injected through a thrombolytic catheter. Swelling reduction, venous patency, and complications of the affected limbs were monitored.Results:In the control group, the difference in thigh circumference before treatment was (4.65 ± 1.06) cm, and after treatment, it was (2.76 ± 1.25) cm. In the observation group, the difference in thigh circumference before treatment was (4.73 ± 1.03) cm, and it was (1.40 ± 0.83) cm after treatment. In the control group, the difference in calf circumference before treatment was (2.24 ± 0.90) cm, and it was (1.56 ± 0.86) cm after treatment. In the observation group, the difference in calf circumference before treatment was (2.40 ± 0.83) cm, and it was (0.80 ± 0.73) cm after treatment. After treatment, the differences in thigh circumference and calf circumference between the healthy and affected sides were statistically significant ( t = 3.58, 2.67, both P < 0.05). After treatment, there was a significant difference in venous patency between the control and observation groups (34.02% [33/97] vs. 68.18% [60/88], t = 3.44, P < 0.05). After 12 months of follow-up, the Villalta scale score, which was used to evaluate post-thrombotic syndrome, was (9.23 ± 4.07) points in the control group, which was significantly different from (5.73 ± 3.39) points in the observation group ( t = 2.62, P < 0.05). Conclusion:Individualized thrombolysis-assisted comprehensive intervention is highly effective in the treatment of DVT in the lower limbs and results in few complications.