摘要
目的探讨CT引导下经皮肾穿刺造瘘术治疗梗阻性肾积水的安全性和可行性。方法 2006年1月-2011年12月,采用CT引导下经皮肾穿刺造瘘术治疗梗阻性肾积水患者49例,术后给予对症治疗,待患者全身情况缓解后行进一步治疗。结果 49例患者共57例肾脏穿刺成功,失败2例,双侧同时置管10例。失败2例及导管脱出3例行开放肾造瘘。36例发热患者依细菌培养结果调整抗生素后1～3 d体温缓解;其中5例因为脓液粘稠堵塞引流管,予以低压庆大霉素液冲洗后缓解。15例合并肾功能不全者术后予以维持水电解质稳定并抗感染治疗,2～14 d内肾功能缓解至Cr 300μmol/L以下。患者全身情况缓解后行相应治疗。结论 CT引导下经皮肾穿刺造瘘术治疗梗阻性肾积水具有成功率高、安全性好、并发症少等优点。能迅速有效地解除上尿路梗阻并及时引流尿液,挽救肾功能,为进一步的治疗赢得时间。
Objective To investigate the effectiveness and feasibiliaty of the CT-guided percutaneous nephrostomy（PCN） in obstructive hydronephrosis. Methods A retrospective analysis of 49 patients was performed in our hospital from January 2006 to December 2011, These patients with obstructive nephropathy were carried out the percutaneous nephrostomy after selected appro- priate puncher spot CT-guide. It was applied symptomatic treatment after operation. Results 49 patients of 57 cases of renal suc- cess and failures in 2 cases（ 10 patients are bilateral）. 2 cases failure and catheters emerge 3 routine open colostomy. 36 cases of renal patients with fever in accordance with the bacteria cultures results after adjustment antibiotics one to three days temperature ease;Five cases because purulent fluid viscous jams the tube, be low voltage gentamycin liquid rinse ease, 15 cases with renal in- sufficiency postoperative maintained the water electrolyte stability and anti-infection treatment,2 - 14 days renal function ease to Cr 300 Ixmol/L. the following patients general condition ease another corresponding treatment. Conclusion It was a high success rate, better safety and low complications of the percutaneous nephrostomy CT-guided. It could relief rapidly hydronephrosis and remedy renal function, for further treatment to win time.
出处
《中华全科医学》
2012年第12期1859-1860,共2页
Chinese Journal of General Practice
