经皮肾穿刺造瘘操作技术及并发症防治探讨  

Discussion of percutanous nephrostomy technique with prevention and treatment of complications

作　　者：张泽富[1] 梁惠民[1] 郑传胜[1] 吴汉平[1] 周国锋[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《介入放射学杂志》2008年第12期868-869,共2页Journal of Interventional Radiology

摘　　要：目的探讨经皮肾穿刺造瘘操作技术,总结并发症产生原因与防治措施。方法回顾性总结采用超声联合透视导向行经皮肾穿刺造瘘治疗247例肾积水患者,分析技术方法及相关并发症情况与防治措施。结果247例在超声联合C臂血管机透视导向下,穿刺置管成功率100%;严重并发症发生率为4例(1.6%),其中3例术后发生大出血,1例术中发生休克,无周围脏器损伤及死亡病例;轻度并发症共25例(10%),包括血尿、尿路感染、穿刺部位血肿、肾周血肿、引流管脱出梗阻、内双J管梗阻移位等。结论熟悉肾造瘘术的操作程序,术前综合评估发生并发症的危险因素,并积极防范处理,可有效提高手术安全性和治疗效果。Objective To analyze the complications and treatment technique of percutaneous nephrostomy. Methods 247 hydronephrosis cases treated with pereutaneous nephrostomy guided by ultrosound and fluroscopy from Januray 2007 to April 2008 were evaluated retrospectively and the causes of complications and suitable treatments were analyzed. Results The successful rate of pereutaneous nephrostomy in 247 hydronephrotie cases reached 100%. In all eases, 4 cases occurred with severe complications （1.6%） including 3 massive hemorrhage and 1 septic shock during the operation. The minor complications（ 25 cases , 10% ） were hematuria, urinary tract infection, local haematoma, perirenal haematoma, detachment of drainage tube with obstruction and exodus, internal double-J catheter displacement and obstruction, etc. Conclusion The operative safety and treatment efficacy of percutaneous nephrostomy could be achieved through skillful management and comprehensive preoperative evaluation of the risk factors for the complications.

关 键 词：超声X线透视 肾造瘘术 并发症 

分 类 号：R699[医药卫生—泌尿科学]