非剥皮鞘法置入球囊导尿管在经皮肾造瘘术中的初探  

A Preliminary Study on the Application of the Non Skinning Sheath Method for the Insertion of a Catheter in Percutaneous Nephrostomy

作　　者：董亮[1] 纪永利[1] 崔文超[1] 张龙云[1] 周青[2] 

机构地区：[1]胜利油田中心医院超声检查科,山东省东营市257034 [2]胜利油田中心医院妇产科,山东省东营市257034

出　　处：《中国超声医学杂志》2017年第10期913-915,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨非剥皮鞘法置入球囊导尿管在经皮肾造瘘术(PCN))中的安全性及有效性。方法利用非剥皮鞘法,在超声引导下对90例102侧肾积水伴肾功能不全患者行PCN治疗,其中12例患者行双肾PCN,比较术前1d和术后7d的肾功能改善情况,观察PCN术后并发症。结果所有90例PCN均一次成功,成功率100%(102/102)。90例术前1dBUN、Cr、GFR分别为(20.58±4.16)mmol/L、(310.58±87.46)μmol/L、(27.1±5.0)ml/min;术后7dBUN、Cr、GFR分别为(6.02±2.46)mmol/L、(118.56±26.48)μmol/L、(50.4±3.4)ml/min。术前1d与术后7dBUN、Cr、GFR有显著统计学差异。术后7d肾功能明显改善者占96.7%(87/90),并发症发生率5.6%(5/90),4周内出现出血伴堵管1例,感染1例,尿外渗1例,结石伴堵管1例,脱管1例,未见严重并发症。结论非剥皮鞘法PCN置入球囊导尿管的方法简便易行,置管成功率高,并发症较少。Objective To investigate the safety and efficacy of the non skinning sheath method in the treatment of percutaneous nephrostomy （PCN）. Methods The use of non stripping sheath method, under the guidance of ultra- sound in 90 cases of hydronephrosis, 102 with renal insufficiency were treated with PCN, including 12 cases of pa dents with renal PCN, comparison of preoperative renal function for 7 days and 1 days after operation to improve the situation,to observe the postoperative complications of PCN. Results All 90 cases of PCN were successfully per- formed with a success rate of 100% （102/102）. In 90 patients 1 days before BUN, Cr, GFR respectively（20.58±4.16）mmol/L, （310.58±87.46）μmol/L, （27.1±5.0）ml/min; after 7 days of BUN, Cr and GFR respectively（6.02±2.46）mmol/L, （118.56±26.48）μmol/L, （50.4±3.4）ml/min. There was significant difference between 1 days before operation and 7 days after operation on BUN, Cr and GFR. After 7 days of renal function improved significantly ac counted for 96.7% （87/90）, the incidence of complications was 5.6% （5/90）, within 4 weeks of hemorrhage with plugging in 1 cases, 1 cases of infection, 1 cases of urinary calculi with extravasation, tube plugging in 1 cases, 1 ca ses, no serious complications. Conclusions The method of PCN catheter with non skinning sheath is simple and con- venient, with high success rate and less complications.

关 键 词：非剥皮鞘法 球囊导尿管 经皮肾造瘘术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R699[医药卫生—诊断学]