利用单腔猪尾巴导管经侧腹部穿刺在肾造瘘中的临床应用价值

Clincal application of using single cavity pig tail catheter through the lateral abdominal puncture in renal fistulization

目的探讨单腔猪尾巴导管作为引流管进行经皮穿刺肾造瘘(percutaneous nephrostomy,PCN)的优势及经侧腹部途径进行PCN的可行性和安全性。方法选取76例95侧肾脏利用单腔猪尾巴导管穿刺进行PCN作为治疗组,选取45例57侧肾脏利用肾盂球囊型导管穿刺进行PCN作为对照组。治疗组中50侧肾脏采取经侧腹部,45侧肾脏采取经腰背部的进针途径;对照组均采取经腰背部进针途径。结果置管一次成功率:治疗组95. 79%(其中采取侧腹部进针96%、腰背部进针95. 56%),对照组85. 96%;治疗组较对照组置管一次成功率高。并发症:治疗组较对照组损伤小且并发症的发生率也有所减少,尤其是出血方面,治疗组为0,对照组出现6例。结论利用单腔猪尾巴导管经侧腹部途径进行PCN较利用肾盂球囊型导管经腰背部途径具有用时短、费用低、损伤小、并发症少的优势,且引流管位于侧腹部,提高了患者术后的舒适度。

Objective To explore the advantages of the pigtail catheter as single cavity drainage tube for pereutaneous puncture renal colostomy （Pereutaneous nephrostomy, PCN） and the feasibility and safety of the lateral abdonfinal approach for PCN. Methods We selected 95 kidneys from 76 eases using single cavity pig tail catheter puncture nephrostomy as the treatment group and selected 57 kidneys of 45 eases using balloon-type catheter puncture nephrostomy as the control group. In the treatment group, 50 kidneys were taken the lateral abdomen kidney as the puncture way, from 45 kidneys were taken the lower back as the puncture way. All kidneys of the control group were taken the lower back as the puncture way. Results The success rate of the first catheterization： the treatment group were 95.79% （among which were taken the lateral abdominal puncture were 96% and were taken the lower back puncture were 95.56% ） , the control group were 85.96%. In comparison to the comtral group, it had lessened damage and lower complication rate, especially in the bleeding, including 4 eases of hematoma and 2 eases of hematuria. Conclusion The advantages of using single pigtail catheter through the lateral abdonfinal cavity PCN are short time, low cost, small damage, fewer complications, and drainage tube located at the side of the abdomen, improve the postoperative patients with eonffort than using type balloon catheter through the small of the back of the renal pelvis.