微创经皮肾造瘘与输尿管镜下置管两种引流方法治疗肾积脓的比较  

Comparison the efficaly of minimally invasive percutanous nephrostomy and transurethral ureteral catheter drainage in the treatment of pyonephrosis

作　　者：廖伟强 罗立旷 陈志权 

机构地区：[1]罗定市人民医院泌尿外科,广东云浮527200

出　　处：《中华腔镜泌尿外科杂志（电子版）》2014年第4期28-31,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的比较微创经皮肾造瘘与经尿道输尿管置管引流治疗肾积脓的疗效及优缺点,旨在指导临床治疗。方法收集2002年6月至2012年6月我院186例肾积脓患者的资料,其中68例行微创经皮肾穿刺造瘘术(实验组),118例行经尿道输尿管置管引流术(对照组),对两种治疗方法、临床疗效及优劣等资料进行评价。结果两组患者年龄,性别,体重指数,发病时间,病史情况、和术前感染指标均无统计学差异(P>0.05)。比较结果提示微创经皮肾穿刺造瘘引流术优于输尿管镜下置管引流术,差异有统计学意义(P=0.027),两组患者手术用时比较差异有统计学意义(P=0.006),术后并发症比较差异无统计学意义(P>0.05)。结论采用微创经皮肾造瘘与输尿管镜下置管两种引流方法治疗肾积脓均安全有效,选择哪种引流方法最终取决于临床情况(患者全身情况、感染严重程度、结石大小、梗阻部位及程度)来制订个体化方案,选择不同的治疗方法。Objective To investigate the effects and advantages of minimally invasive percutanous nephrostomy and transurethral ureteral catheter drainage in the treatment of pyonephrosis. Methods A retrospective analysis about clinical data of 68 patients with the Pyonephrosis treated with minimally invasive percutanous nephrostomy and 118 patients treated with transurethral ureteral catheter drainage. Data were collected fi：om June 2002 to June 2012. Evaluated the effects and its benefits and other information form two groups. Results The clinical data between the minimally invasive surgery and transurethral ureteral catheter drainage had no significant difference （/：＇〉0.05）. Our study showed that the efficacy of minimally invasive surgery was better than ureteroscopy catheter drainage （P=0.027）. The difference of operation time between the two groups were significant （P=0.006）. There were no significant difference in complications between the two groups. Conclusions Both minimally invasive percutanous nephrostomy and transurethral ureteral catheter drainage are safe and effective for the treatment of Pyonephrosis. Choose which kind of drainage method finally depends on the clinical situation （patient general condition, infection severity, stones size, position and degree of obstruction） to develop individualized programs.

关 键 词：脓肾 经皮肾造瘘 输尿管镜 

分 类 号：R699[医药卫生—泌尿科学]