糖尿病并发气肿性肾盂肾炎临床分析并文献复习  

Diabetic Patients with Emphysematous Pyelonephritis:Clinical Experience and Review of the Literature

作　　者：陈少安[1] 孟慧林[1] 李斌[1] 张涛[1] 康维亭 

机构地区：[1]山东大学附属省立医院泌尿微创中心,山东济南250014

出　　处：《泌尿外科杂志（电子版）》2014年第4期31-33,共3页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的探讨气肿性肾盂肾炎(emphysematous pyelonephritis,EPN)的临床表现、病因学、诊断及治疗方法。方法对本院收治的一例临床确诊为气肿性肾盂肾炎患者的资料进行总结分析,并通过文献复习进一步总结。结果气肿性肾盂肾炎好发于成人女性糖尿病患者,病情急发且危重、死亡率高,CT为最佳影像诊断方法,治疗方法既往常选择肾切除,近年更多选择抗感染加外引流或内引流的方法。结论气肿性肾盂肾炎为肾实质和肾周的产气性感染,病情凶险,选择CT检查为宜,并及时抗感染并外引流/内引流,必要时选择肾切除。Objective To investigate the clinical manifestations,etiology,diagnosis and treatment of EPN. Methods A clinical confirmed case in our hospital was reported,literatures between 1898 and 2014 with histo-logically confirmed EPN were reviewed,and its management is then presented. Results All the documented ca-ses of EPN have been in adult females with diabetes,EPN is potentially life-threatening conditions with high mortality. CT should be considered the imaging modality of choice. Nephrectomy was commonly chosen previ-ously and antibiotic treatment combined internal drainage (or external drainage)was presently chosen. Conclu-sions EPN is a rare,severe,necrotizing form of renal infection characterized by the presence of gas within the renal parenchyma or perinephric space. CT is both highly sensitive and specific in the detection of gas. Initial management of EPN includes resuscitation,antibiotic treatment targeting Gram-negative bacterias combined in-ternal drainage (or external drainage),Nephrectomy should be taken when deterioration.

关 键 词：气肿性肾盂肾炎 糖尿病 

分 类 号：R692.7[医药卫生—泌尿科学] R587.2[医药卫生—外科学]