经皮肾穿刺引流术在梗阻性肾功能衰竭治疗中的应用  

Application of percutaneous renal puncture drainage in the treatment of obstructive renal failure

作　　者：马纪 赵声龙 Ma Ji;Zhao Sheng-long(Department of Urology,Zhaotong First People's Hospital,Zhaotong 657099,Yunnan,China)

机构地区：[1]昭通市第一人民医院泌尿外科,云南昭通657099

出　　处：《四川生理科学杂志》2022年第7期1139-1141,共3页Sichuan Journal of Physiological Sciences

基　　金：云南省器官移植临床医学中心专项经费(项目编号:ZX2019-07-01)。

摘　　要：目的:探讨超声引导经皮肾穿刺造瘘术对治疗梗阻性肾功能衰竭的临床价值,并以该方法为核心建立相关诊疗体系。方法:对2019年1月至2021年9月在昭通市第一人民医院就诊的21名因肿瘤或泌尿系结石等原因导致的梗阻性肾功能衰竭的患者进行超声引导下经皮肾穿刺造瘘术,记录手术过程及观察术后肾功能恢复情况,并在随访中了解患者术后短期内的恢复情况。结果:穿刺手术均进行顺利:16例患者穿刺后引流液清亮,其余5例患者穿刺后不同程度出血,对症处理后引流液均变清亮且引流通畅,所有病例未见明显严重并发症。大部分患者在穿刺后2-5d内肾功能均有不同程度好转。在持续随访的定期更换肾造瘘管的患者中,部分患者肾功能恢复至不需定期行肾透析程度。结论:对于难以立即解除梗阻因素的梗阻性肾功能衰竭,超声引导行肾穿刺引流术能快捷、有效改善肾功能,并且经济成本低,成功率高,并发症少,具有较高实用价值。Objective:To investigate the clinical value of ultrasound-guided percutaneous nephrostomy in the treatment of obstructive renal failure,and to establish a diagnosis and treatment system based on this method.Methods:In January 2019 to September 2021 in Zhaotong First People's Hospital of 21 patients due to reasons such as tumors or urinary tract calculi with obstructive renal failure for ultrasound guided percutaneous renal puncture colostomy,record the operation process and observe the postoperative renal function recovery,and understand the short term in the follow-up of patients with postoperative recovery.Results:All the puncture operations were successful:the drainage fluid was clear after puncture in 16 cases,while the other 5 patients had bleeding of varying degrees after puncture.After symptomatic treatment,the drainage fluid was clear and the drainage was smooth,and no obvious serious complications were observed in all cases.The renal function of most patients improved to varying degrees within 2-5 days after puncture.In patients with recurrent renal fistula replacement with continuous follow-up,some patients recovered renal function to the extent that regular renal dialysis was not required.Conclusion:Ultrasound-guided renal puncture and drainage can improve renal function quickly and effectively in patients with obstructive renal failure which is difficult to remove the obstructive factors immediately.Low economic cost,high success rate,less complications,high practical value.

关 键 词：梗阻性肾功能衰竭 经皮肾穿刺造瘘引流术 肾功能 

分 类 号：R47[医药卫生—护理学]