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作者对7例患者成功使用逆行技术经皮肾造痿,平均肾造瘘时间约46分钟,平均荧光屏观察时间仅3分钟,无任何手术并发症。逆行技术的优点是迅速、安全,几乎无照射,特别适于无扩张的收集系统及有肾周瘢痕的患者。 Lawson技术:全麻、截石位,电视监视下经膀胱镜将0.038inch的弯头导丝插入输尿管,套入Teflon导管后拔出导丝,注入造影剂,了解收集系统解剖。反向旋转手术床和C型臂,通过收集系统侧面观确定后侧肾盏。将可操作导丝插入7F Teflon导管,电视下操纵导管,使其进入预选肾盏。拔出导丝,换入带不锈钢鞘的穿刺导丝,穿索导丝向上通过Teflon导管时应与鞘锁住。穿刺导丝尖端达Tefon导管外时,电视下检查穿刺导丝的角度。如导丝过于朝向尾端,稍后退7 F导管即可纠正:如过于朝向头端,可稍推进7 F导管。打开穿刺导丝与鞘上的锁,电视下推进导丝,穿过肾实质、肾周脂肪、腹壁,直
The authors successfully retrospectively performed retrospective techniques on 7 patients with peritoneal nephrotic implants. The average time for nephrostomy was about 46 minutes. The average fluoroscopic screen time was only 3 minutes without any complications. The advantages of retrograde technology are rapid, safe and almost no radiation, especially for non-expanding collection systems and patients with scarring of the kidney. Lawson technology: general anesthesia, lithotomy position, TV monitoring cystoscope through the 0.038inch elbow guide wire into the ureter, Teflon catheter set after pulling out the guide wire, injection of contrast media to understand the collection system anatomy. Reverse rotation of the operating bed and C-arm, lateral view through the collection system to determine the side of the calyx. The operable guidewire was inserted into the 7F Teflon catheter and the catheter was steered under the television to bring it into the pre-selected calyx. Pull out the guide wire, into the puncture guide wire with a stainless steel sheath, through the Teflon catheter through the guide wire should be locked with the sheath. Puncture the tip of the guide wire to the outside of the Tefon catheter and check the angle of the guide wire under the TV. If the guidewire is too far to the caudal end, retract the 7F catheter later to correct it: If it is too far toward the end, push the 7 F catheter slightly. Open the piercing guide wire and the lock on the sheath, guide wire under the TV, through the renal parenchyma, perirenal fat, abdominal wall, straight