经皮肾穿刺微造瘘术在上尿路梗阻的应用

摘要

目的 介绍B超引导下经皮肾穿刺微造瘘术(mPCN)在上尿路梗阻性疾病的临床应用.方法 54例上尿路梗阻的患者采用B超经皮肾穿刺微造瘘术(mPCN)引流尿液后,再根据病因、梗阻部位、肾功能状态、有无继发感染、患者的基本状态等进一步决定治疗方案.结果 14例肾功能衰竭患者肾功能明显改善,46例通过手术取出结石,3例矫形解除狭窄,5例患肾无功能采取肾切除术.结论 B超引导经皮肾微造瘘术可以迅速引流尿液,改善肾功能,控制感染,有助于进一步完善检查,判断患肾的功能及预后,为制定治疗方案提供依据,用于早期处理上尿路梗阻性病变是一种安全、有效、简单、经济的方法.%To concluded the clinical experience of mini-percutancous nephroscopy (mPCN) in the treatment of upper urinary tract obstruction (UUTO). Methods 54 cases with UUTO were underwent mPCN guided by the B-ultrasonic to drain the urine, then according to the pathogenesis, obstruction position, renal function,with or without secondary infection, the basic state of patients to decided the further treatment. Results After mPCN,49 cases of renal function were improving, 14 cases of patients' renal function was improved among patients with renal failure, 47 cases removed the stones by surgery, 3 cases through orthotics relieve stenosis, 5 cases of non-functioniag kidney patients resort to nephrectomy. Conclusion mPCN guided by the B-ultrasonic can drain the urine quickly,improve the renal function, control the infection, help to improve the further inspection, determine the renal function and prognosis, provide the basis for the therapeutic schedule, and is safe, effective, simple and economic ia the treatment of UUTO.