B超引导下运用中心静脉导管行一步法微创经皮肾造瘘术的临床应用  

Clinical Application of One-step Minimally Invasive Percutaneous Nephrostomy with Central Venous Catheter Guided by B-ultrasound

作　　者：许炯煊 钟德文 董兴模 陈钦棋 XU Jiong-xuan;ZHONG De-wen;DONG Xing-mo;CHEN Qin-qi(Longyan First Hospital Affiliated to Fujian Medical University No.105,Xinluo District,Longyan,Fujian Province,364000 China)

机构地区：[1]福建医科大学附属龙岩第一医院

出　　处：《中外医疗》2019年第34期68-70,共3页China & Foreign Medical Treatment

摘　　要：目的探讨B超引导下运用中心静脉导管行一步法微创经皮肾造瘘术的应用价值。方法该院从2015年6月—2018年11月共开展B超引导下运用中心静脉导管行一步法微创经皮肾造瘘术77例,观察患者术前术后的症状,体征及并发症。比较血肌酐、尿素氮、血红蛋白等的变化。结果77例患者一次性经皮肾穿刺造瘘成功,15例晚期肿瘤患者术前与术后1周血肌酐[(686.45±215.55)μmol/L vs(333.6±181.79)μmol/L(t=12.549)]、血尿素氮[(36.12±19.37)mmol/L vs(19.36±9.59)mmol/L(t=10.303)],差异有统计学意义(P<0.05),血色素[(89.4±18.41)g/L vs(87.73±19.14)g/L(t=2.032)],差异无统计学意义(P>0.05),所有患者术中、术后未见明显大出血和其他并发症。结论B超引导下运用中心静脉导管行一步法微创经皮肾造瘘术解除上尿路梗阻效果肯定,安全可靠。Objective To investigate the clinical application value of one-step percutaneous nephrostomy with central venous catheter under the guidance of medical ultrasonography.Methods From June 2015 to November 2018,77 cases of patients were treated by one-step percutaneous nephrostomy with central venous catheter under the guidance of medical ultrasonography in our hospital.The symptoms,signs and complications before and after operation were observed.We compar the change of serum creatinine,blood urea nitrogen and hemoglobin.Results All cases succeeded,there were significant differences in serum creatinine[(686.45±215.55)μmol/L vs(333.6±181.79)μmol/L(t=12.549)],blood urea nitrogen[(36.12±19.37)mmol/L vs(19.36±9.59)mmol/L(t=10.303)]before and one week after operation in 15 patients with advanced tumors(P<0.05),there was no significant difference in hemoglobin[(89.4±18.41)g/L vs(87.73±19.14)g/L(t=2.032)](P>0.05).The operation didn’t cause serious complications,for example:serious hemorrhage,etc.Conclusion The effect of relieving upper urinary tract obstruction with one-step percutaneous nephrostomy with central venous catheter under the guidance of medical ultrasonography?is affirmative and safe.

关 键 词：中心静脉导管 微创经皮肾造瘘术 上尿路积水 

分 类 号：R4[医药卫生—临床医学]