经皮肾术治疗结石梗阻性脓肾

摘要

Objective To assess the efficacy and safety of treatment for caculous pyonephrosis with ultrasound-guided direct puncture drainage catheter placement and minimally invasive percutaneous nephrolithotomy (MPCNLs). Methods In 50 patients of caculous pyonephrosis,ultrasound-guided direct puncture drainage catheter placement was performed firstly. Then MPCNLs was underwent to manage calculi. Results In all 50 patients, satisfactory drainage catheter placement was achieved in 55 renal units. No major complications like hemorrhage, sepsis or periorgan damage were encountered in any of the patients. The immediate stone-free rate was 94%. Conclusion Ultrasound-guided direct puncture drainage catheter placement is a rapid, effective, safe, and minimum rate of complication in treatment for caculous pyonephrosis. MPCNL based on drainage is an effective, safe and reliable technique.%目的：评估超声引导下的利用直接穿刺型引流导管进行经皮肾造瘘术引流脓肾和微通道经皮肾碎石术治疗结石梗阻性脓肾的有效性和安全性。方法50例结石梗阻性脓肾患者，首先超声引导下利用直接穿刺型引流导管进行经皮肾造瘘术引流脓肾，而后行经皮肾镜钬激光碎石术治疗。结果50例患者共行55侧超声引导下经皮肾穿刺造瘘术置管引流，置管全部一次性成功，无严重出血，感染性休克，周围脏器损失等并发症。50例侧行微通道经皮肾镜碎石术治疗，单次结石清除率94%。术中、术后无严重并发症。结论超声引导下经皮肾穿刺造瘘术治疗结石梗阻性脓肾，具有操作简单、准确性及安全性好、成功率高、并发症少等优点，在此基础上进行的微通道经皮肾镜钬激光碎石术安全、有效，单次净石率高。