【摘要】 目的:探讨经皮肾穿刺造瘘(PCN)在梗阻性肾功能不全诊治中的临床价值。方法:对49例梗阻性肾功能不全患者在B超引导下行PCN引流肾积水(脓),经造瘘管造影了解梗阻原因及部位,病情好转稳定后手术解除梗阻。结果:45例患者经引流后BUN、Cr均有下降,手术解除梗阻后恢复好。4例患者经引流后BUN、Cr无明显下降,继续行血透治疗。无死亡病例。结论:在梗阻性肾功能不全的诊治中,PCN能尽快引流肾积水(脓),改善肾功能,避免血液透析或减少血透次数,减轻患者经济负担;可动态监测肾功能变化,避免治疗上的盲目性;建立的通道为二期手术打开方便之门,尤其是结石梗阻性肾功能不全诊治具有重要的应用价值;使急症手术变为择期手术,降低了手术死亡率及术后并发症发生率;同时经肾造瘘管造影可提高诊断符合率。这种方法微创安全,简单有效,经济实惠,值得推广。更多还原

【Abstract】 Objective:To exploit the worth of clinical of diagnosing and treating in obstructive renal failure with percutaneous nephrostomy(PCN) under the B-ultrasound guiding.Methods:49 patients were treated with obstructive renal failure with percutaneous nephrostomy under the B-ultrasound guiding.To find out the obstructive reasons and locals by pouring contrast media in with ostomy tube,meanwhile,drain the hydronephrosis,and have operation to remove obstruction after their stable states of illnesses.Results:Obstructive reasons and sites were found out by contrast media in 49 cases.Of 45 cases serum Bun and Cr both drop,45 cases easily recover after operative removing obstruction.Conclusions:Percutaneous nephrostomy provides available passage for further diagnosis and treatment in the obstructive renal failure,especially in calculus obstruction renal failure.These methods are minimally invasive and safe,simple and effective,cheap and thus worth spreading.更多还原