CAJ | 학술논문

目的探讨经皮肾穿刺造瘘术(PCN)治疗肾后性急性肾功能衰竭(PARF)患者的效果及应用价值.方法回顾性总结分析40例PARF患者在B超引导下行PCN的临床资料,并与20例行常规开放手术患者进行对比.结果肾穿刺组PCN成功率为100%,引流后2～7 d,患者肾功能均恢复正常;治愈30例;长期留置肾造瘘管10例,其中2例为腹腔继发肿瘤患者,8例为宫颈癌晚期患者;无一例死亡、无造瘘后肾周血肿和胸膜损伤发生,未出现术后感染、多器官功能衰竭等并发症.开放手术组于引流后2～7 d 19例患者肾功能恢复正常,其中术后出现肺部感染3例,经抗感染、对症治疗后好转;多器官功能衰竭死亡1例.结论 PCN具有创伤小、出血少的优点,对挽救PARF患者肾脏功能有重要价值.
목적 탐토경피신천자조루술(PCN)치료신후성급성신공능쇠갈(PARF)환자적효과급응용개치.방법 회고성총결분석40례PARF환자재B초인도하행PCN적림상자료,병여20례행상규개방수술환자진행대비.결과 신천자조PCN성공솔위100%,인류후2～7 d,환자신공능균회복정상;치유30례;장기류치신조루관10례,기중2례위복강계발종류환자,8례위궁경암만기환자;무일례사망、무조루후신주혈종화흉막손상발생,미출현술후감염、다기관공능쇠갈등병발증.개방수술조우인류후2～7 d 19례환자신공능회복정상,기중술후출현폐부감염3례,경항감염、대증치료후호전;다기관공능쇠갈사망1례.결론 PCN구유창상소、출혈소적우점,대만구PARF환자신장공능유중요개치.
Objective To investigate the effects and clinical value of percutaneous nephrostomy (PCN) in the management of postrenal acute renal failure (PARF). Methods The clinical data of 40 cases of PARF for the treatment of PCN and 20 cases with open surgery were retrospectively analyzed. Results The success rate of PCN was 100%, renal function of all patients was restored to normal range after 2-7 days of PCN, in whom 30 patients recovered. In 10 patients nephrpostomy was prolonged, among them 2 patients had recurrent abdominal tumors, and 8 patients had cervical cancer in late phase. There was no death, and no complications except hematuria. In the open surgery group, renal function of 19 cases recovered to normal range after 2-7 days of drainage. Lung infection occurred in 3 patients after operation,and they recovered with antibiotic therapy. One patient died of multiple organ dysfunction failure (MOF).Conclusion For PARF, PCN is preferable because of minimal trauma, less blood loss, as well as rapid recovery and better effect on recovery of renal function.