经皮肾穿刺造瘘术与开放手术治疗肾后性急性肾功能衰竭的疗效对比分析

目的 探讨经皮肾穿刺造瘘术(PCN)治疗肾后性急性肾功能衰竭(PARF)患者的效果及应用价值.方法 回顾性总结分析40例PARF患者在B超引导下行PCN的临床资料,并与20例行常规开放手术患者进行对比.结果 肾穿刺组PCN成功率为100%,引流后2～7 d,患者肾功能均恢复正常;治愈30例;长期留置肾造瘘管10例,其中2例为腹腔继发肿瘤患者,8例为宫颈癌晚期患者;无一例死亡、无造瘘后肾周血肿和胸膜损伤发生,未出现术后感染、多器官功能衰竭等并发症.开放手术组于引流后2～7 d 19例患者肾功能恢复正常,其中术后出现肺部感染3例,经抗感染、对症治疗后好转;多器官功能衰竭死亡1例.结论 PCN具有创伤小、出血少的优点,对挽救PARF患者肾脏功能有重要价值.

A comparison of curative effects of percutaneous nephrostomy and open surgery in the management of postrenal acute renal failure

OBJECTIVE: To investigate the effects and clinical value of percutaneous nephrostomy (PCN) in the management of postrenal acute renal failure (PARF). METHODS: The clinical data of 40 cases of PARF for the treatment of PCN and 20 cases with open surgery were retrospectively analyzed. RESULTS: The success rate of PCN was 100%, renal function of all patients was restored to normal range after 2-7 days of PCN, in whom 30 patients recovered. In 10 patients nephrpostomy was prolonged, among them 2 patients had recurrent abdominal tumors, and 8 patients had cervical cancer in late phase. There was no death, and no complications except hematuria. In the open surgery group, renal function of 19 cases recovered to normal range after 2-7 days of drainage. Lung infection occurred in 3 patients after operation, and they recovered with antibiotic therapy. One patient died of multiple organ dysfunction failure (MOF). CONCLUSION: For PARF, PCN is preferable because of minimal trauma, less blood loss, as well as rapid recovery and better effect on recovery of renal function.