CAJ | 학술논문

目的：探讨气肿性肾盂肾炎（emphysematous pyelonephritis，EPN）的临床表现、病因学、诊断及治疗方法。方法对本院收治的一例临床确诊为气肿性肾盂肾炎患者的资料进行总结分析，并通过文献复习进一步总结。结果气肿性肾盂肾炎好发于成人女性糖尿病患者，病情急发且危重、死亡率高，CT为最佳影像诊断方法，治疗方法既往常选择肾切除，近年更多选择抗感染加外引流或内引流的方法。结论气肿性肾盂肾炎为肾实质和肾周的产气性感染，病情凶险，选择CT检查为宜，并及时抗感染并外引流／内引流，必要时选择肾切除。
목적：탐토기종성신우신염（emphysematous pyelonephritis，EPN）적림상표현、병인학、진단급치료방법。방법대본원수치적일례림상학진위기종성신우신염환자적자료진행총결분석，병통과문헌복습진일보총결。결과기종성신우신염호발우성인녀성당뇨병환자，병정급발차위중、사망솔고，CT위최가영상진단방법，치료방법기왕상선택신절제，근년경다선택항감염가외인류혹내인류적방법。결론기종성신우신염위신실질화신주적산기성감염，병정흉험，선택CT검사위의，병급시항감염병외인류／내인류，필요시선택신절제。
Objective To investigate the clinical manifestations,etiology,diagnosis and treatment of EPN. Methods A clinical confirmed case in our hospital was reported,literatures between 1898 and 2014 with histo-logically confirmed EPN were reviewed,and its management is then presented. Results All the documented ca-ses of EPN have been in adult females with diabetes,EPN is potentially life-threatening conditions with high mortality. CT should be considered the imaging modality of choice. Nephrectomy was commonly chosen previ-ously and antibiotic treatment combined internal drainage (or external drainage)was presently chosen. Conclu-sions EPN is a rare,severe,necrotizing form of renal infection characterized by the presence of gas within the renal parenchyma or perinephric space. CT is both highly sensitive and specific in the detection of gas. Initial management of EPN includes resuscitation,antibiotic treatment targeting Gram-negative bacterias combined in-ternal drainage (or external drainage),Nephrectomy should be taken when deterioration.