CT导向经皮肾穿刺造瘘的临床应用

目的：探讨CT导向经皮肾穿刺造瘘对尿路梗阻患者的临床价值。方法：回顾性分析18例不同原因尿路梗阻所致肾积水（脓）的危重患者，其中输尿管结石¨例（双侧8例，单侧3例），肿瘤腹膜后转移侵犯6例（直肠癌术后腹膜后转移侵犯2例，宫颈癌术后腹膜后侵犯2例，胃癌术后腹膜后淋巴结转移2例），左侧输尿管癌术后复发侵犯右侧输尿管1例。结果：18例23侧肾脏均在CT引导下成功置管，外引流通畅，梗阻解除，术后18例患者肾功能明显恢复，感染症状得到控制，术后效果满意，无严重并发症。结论：CT导向经皮肾穿刺造瘘对危重不能手术或暂时不宜手术的梗阻性肾积水或积脓患者的病情缓解有良好效果，能为二期手术创造良好条件或延长患者生命，具有较大的临床价值。

Clinical application of percutaneous nephrostomy under CT guidance

Objective：To explore the value of CT-guided percutaneous nephrostomy for patients with urinary tract ob struction. Methods： 18 cases of urinary tract obstruction with different causes were retrospectively analyzed,including 11 pa tients diagnosed as ureteral calculi, 6 patients diagnosed as retroperitoneal tumor invasion, and one patient diagnosed as inva sion of the right ureter by recurrence of left ureter carcinoma. Results：In 18 cases, 23 kidneys were catheterized successfully, the external drainage was free and easy and the obstruction was relieved. After operations, 18 patients all got obvious recov-ery in renal functions,the symptoms of infection were under control. Conclusion： CT-guided percutaneous nephrostomy can reduce symptoms for patients with obstructive hydronephrosis or pyonephrosis who are critically ill, being unable to receive operation or temporary unfavorable for a surgical operation. This will create good conditions for a secondary operation, thus prolong the patient＇s life. So the CT-guided percutaneous nephrostomy has a high value in clinical application.