B超联合DSA下急诊经皮肾穿刺造瘘治疗急性梗阻性肾盂化脓的临床效果

Clinical effect of ultrasound combined with DSA in emergency percutaneous nephrostomy of patients with acute obstructive pyonephrosis

目的:探讨在B超联合数字减影血管造影(DSA)透视下急诊经皮肾穿刺造瘘治疗急性梗阻性肾盂化脓的临床效果。方法:选取2015年6月至2017年6月在我科接受急诊经皮肾穿刺造瘘治疗的31例急性梗阻性肾盂化脓患者。比较治疗前后的血白细胞计数(WBC)、中性粒细胞比例(NEUR)、C反应蛋白(CRP)和降钙素原(PCT)等感染性指标变化情况。结果:31例患者接受35次经皮肾穿刺造瘘治疗,其中单侧经皮肾穿刺造瘘27例,双侧4例。术后3 d的血WBC、NEUR、CRP和PCT较术前均明显下降,差异有统计学意义。结论:B超联合DSA透视下急诊经皮肾穿刺造瘘治疗急性梗阻性肾盂化脓成功率高,并发症少,同时积极进行抗感染治疗,能明显改善患者的预后。

Objective:To investigate the clinical effect of ultrasound combined with DSA in emergency percutaneous nephrostomy of patients with acute obstructive pyonephrosis.Methods:From June 2015 to June 2017,31 patients with acute obstructive pyonephrosis underwent percutaneous nerphrostomy in our department.The clinical data,such as WBC,NEUR,CRP and PCT were analyzed before and after percutaneous nerphrostomy.Results:Thirty-one patients were treated with emergency percutaneous nerphrostomy,including 27 unilateral and 4 bilateral percutaneous nerphrostomy.The total number was 35 times of percutaneous nerphrostomy.After 3 d of procedure,the data of WBC,NEUR,CRP and PCT declined obviously compared with those before procedure,and the difference was statistical.Conclusion:Ultrasound combined with DSA for the emergency treatment of patients with acute obstructive pyonephrosis with high surgical success rate and fewer complications could significantly improve the prognosis of patients combined with anti-infection treatment.