B超引导下经皮经肾肾盂造瘘术的护理

目的探讨B超引导下经皮经肾肾盂造瘘术的护理方法。方法回顾性分析50例盆腔恶性肿瘤及肾结石所致肾盂积水患者，在DSA及B超导引下行经皮经肾肾盂造瘘外引流治疗的护理经过，包括术前护理、术中配合、术后护理、出院指导等。结果满意放置导管造瘘成功率98％，穿刺失败1例，预期换管60例，意外拔管3例，其中2例为健康教育不到位，患者自行剪掉造瘘管内固定线致脱落，1例为换管不慎滑脱致重新置管，无1例严重并发症。结论实时超声引导经皮肾穿刺造瘘术成功率高、安全、可靠、有针对性的护理措施是治疗成功的关键。

Nursing care ways of ultrasound-guided percutaneous nephrostomy

Objective To study the nursing care ways of ultrasound-guided percutaneous nephrostomy （PCN）. Methods We retrospectively analyzed 50 cases of nephrydrosis caused by pelvic malignant tumors or renallithiasis. All of them were treated by ultrasound-guided percutaneous nephrostomy（PCN） with the help of DSA. We studied the preoperative and postoperative nursing care ways of these patients as well as the cooperation with the operators during the operations. We also studied the advisable advice when they were discharged from the hospitals. Results The successful rate of the operation was 98%, one of the patients was failed to puncture. Sixty cases were exchanged the draining duct as expected. Three cases were extubated by accident, 2 of which were unsuitably educated and lwas extubated when he was exchanged the draining duct. There was no severe complication. Conclusion Real-time Ultrasound-B-guided percutaneous nephrostomy（PCN） is an available, effective and safe therapy to patients of nephrydrosis caused by pelvic malignant tumors or renal lithiasis. Advisable nursing care ways play a very important role in these patients.