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目的探讨超声引导下经皮穿刺肾造瘘(percutaneous nephro stomy,PCN)治疗梗阻性肾病的临床价值及疗效。方法在彩超引导下,选择腋后线肾中部作为穿刺点,常规皮肤消毒,采用1%利多卡因局部浸润麻醉,徒手用18 g PTC针穿刺至肾盂后,置入J型导丝于肾盂内,置入扩张管,扩张针道后置入7F单双猪尾巴导管引流。结果共穿刺造瘘52例患者,60个肾脏,同时行双侧穿刺造瘘8例,均一次穿刺造瘘置管成功,穿刺置管后未出见肾周血肿、肾盂损伤等严重并发症,患者血清肌酐在穿刺置管后有显著下降。结论超声引导下经皮穿刺肾造瘘术成功率高、创伤小、安全、可靠,能有效改善肾功能,具有非常重要的临床意义。
Objective To investigate the clinical value and curative effect of ultrasound-guided percutaneous nephrostomy (PCN) in the treatment of obstructive nephropathy. Methods Under the guidance of ultrasound, axillary midline of axilla was selected as the puncture point. The skin was disinfected by conventional method. Local anesthesia was performed with 1% lidocaine. After 18 g PTC needle was punctured to the renal pelvis by hand, the J- , Into the dilation tube, dilated needle into the 7F single pig tail catheter drainage. Results A total of 52 cases of puncture fistula and 60 kidneys were treated with bilateral puncture and fistula in 8 cases. All the puncture fistulas were successfully punctured. After puncture and catheterization, no serious complications such as perirenal hematoma and renal pelvis injury were seen. Patients with serum creatinine after puncture catheter significantly decreased. Conclusion Ultrasound-guided percutaneous nephrostomy has a high success rate, small trauma, safety and reliability, and can effectively improve renal function. It has very important clinical significance.