中心静脉导管在行经皮肾造瘘术中的应用

Utilization central venous catheter for percutaneous nephrostomy

目的:评价中心静脉导管行经皮肾造瘘术临床应用效果。方法:120例需行肾造瘘术的患者随机分为二组:导管组65例,应用中心静脉导管行经皮肾造瘘术;传统组55例,采用传统经皮肾逐步扩张造瘘术。对两组的穿刺次数、手术时间、出血量、手术费用及术后的并发症进行比较。结果:导管组在平均手术时间、术中平均出血量、一次穿刺成功例数、发生并发症例数及平均费用均明显低于传统组,两组比较有统计学意义;两组在平均穿刺次数上无显著性差异,但导管组一次穿刺置入造瘘管的成功率明显高于传统组。结论:应用中心静脉导管行经皮肾造瘘术较传统方法有出血少、一次穿刺成功率高、术后并发症少、操作简便等优点,且经济、安全、有效,值得临床推广应用。

Objective：To evaluate the efficacy and safety of using central venous catheter percutaneous nephrostomy. Methods： 120 cases of needed nephrostomy in our hospital were recruited randomly in two groups for percutaneous nephrostomy. 65 cases in central venous catheter group were used central venous catheter percutaneous nephrostomy. 55 cases utilized traditional fascial dilators percutaneous nephrostomy. The puncture frequence, operatating time, estimated blood loss, operating cost and complications were compared. Results：There were significant difference in mean opertaint time, estimated blood loss, one time puncture succeed case, complications and operation cost between central venous catheter group and traditional group. There was no significant difference in average puncture frequency between two groups. The successful rate of one time puncture in central venous catheter group was higher than the traditional group. Conclusions：The procedure of using central venous catheter percutaneous nephrostomy is less bleeding,more successful, less complications, more convenien when comparing to the traditional fascial dilating method, It is a economical, safely, effective method which is worth extending to use in clinic.