经皮肾穿刺造瘘在急性肾后性肾衰诊治中的作用

The role of percutaneous nephrostomy in the management of postrenal acute renal failure

目的：探讨经皮肾穿刺造瘘术在急性肾后性肾衰患者诊治中的作用。方法：回顾性总结28例肾后性急性肾衰的临床资料。14例行ESWL，6例行输尿管镜治疗，开放手术2例，保守治疗4例。在B超引导下肾脏穿刺造瘘25例。结果：24例为上尿路结石引起；14例为功能性孤立肾。引流后2～7天，28例肾功能均恢复正常。本组26例治愈，2例长期留置肾造瘘管，均无造瘘后出血和感染发生。结论：经皮肾穿刺造瘘对急性肾后性肾衰患者挽救肾脏功能有重要价值，B超定位可以显著增加成功率。

Objective： To evaluate the role of percutaneous nephrostomy（PCN） in the management of acute postrenal renal failure. Methods.. The clinical date of 28 cases （men 21, women 7）of acute postrenal renal failure were retrospectively analyzed . Anuria in 20, oliguria in 8 ; Crl 162.5-2234.6μmol/L, with mean value（768.5 ±326. 4）μmol/L. 3 patients with retroureteral catheterization under cystoscopy and 25 cases with PCN under 13 ultra sound. Results： The cause of 24 cases is obstruction of upper urinary tract by calculus. 20 cases of functionally solltary kidney were observed. 14 cases were treated with ESWL,6 cases with ureteroscopy,4 cases with conservative measures and 2 cases with open operation. 26 cases recovered and 2 cases reserved nephrostomy catheter. Conclusions：For acute postrenal renal failure , PCN retrieve renal function and avoid hemodialysis, is safe and effective, B ultrasound can increase the achievement ratio.