CAJ | 학술논문

目的：：探讨B超引导下局麻经皮肾镜取石术( percutaneous nephrolithotomy,PCNL )治疗结石性脓肾的疗效。方法：37例结石性脓肾在超声引导局麻下一期行肾穿刺引流脓液,待临床情况好转后进行二期标准通道PCNL治疗。结果：37例均穿刺成功,解除梗阻,其中30例患者患侧肾功能恢复正常,7例患侧肾功能改善。二期标准通道PCNL手术时间25~84 min。结石均取净,未出现严重全身炎症反应综合征、严重出血等并发症。住院10~21 d。结论：一期肾穿刺引流脓液,解除尿路梗阻,可以提高二期PCNL碎石的安全性,对结石性脓肾治疗有重要意义。
목적：：탐토B초인도하국마경피신경취석술( percutaneous nephrolithotomy,PCNL )치료결석성농신적료효。방법：37례결석성농신재초성인도국마하일기행신천자인류농액,대림상정황호전후진행이기표준통도PCNL치료。결과：37례균천자성공,해제경조,기중30례환자환측신공능회복정상,7례환측신공능개선。이기표준통도PCNL수술시간25~84 min。결석균취정,미출현엄중전신염증반응종합정、엄중출혈등병발증。주원10~21 d。결론：일기신천자인류농액,해제뇨로경조,가이제고이기PCNL쇄석적안전성,대결석성농신치료유중요의의。
Objective:To evaluate the clinical application of the percutaneous nephrolithotomy( PCNL) guided by B ultrasound in the treatment of calculous pyonephrosis under local anesthesia. Methods:Thirty-seven cases with calculous pyonephrosis were treated with phaseⅠrenal biopsy to drain pus guided by B ultrasound under local anesthesia,then the patients were treated with phaseⅡstandard channel percutaneous nephrolithotomy when the general conditions of patients were improved. Results:Thirty-seven cases were successfully punctured and removed the obstruction, the ipsilateral renal function in 30 cases and 7 cases recovered to normal and improved,respectively. The operation time of phase Ⅱ standard channel percutaneous nephrolithotomy was 25 to 84 min. No residual stones,systemic inflammatory response syndrome and severe bleeding in all cases were found,and the hospitalization time was 10 to 21 d. Conclusions:Phase Ⅰ renal biopsy drainage of pus and removing urinary tract obstruction can improve the security of the phase 2 PCNL,which has an important significance in treating calculus pyonephrosis.