肾周脓肿25例的诊断与治疗

目的：提高肾周脓肿的诊断与治疗水平。方法：回顾性分析25例肾周脓肿患者的临床资料。结果：25例患者明确诊断为肾周脓肿，72％患者尿培养阳性，CT确诊率92％。3例(12％)死亡。10例患者脓肿直径1.8cm，单独使用抗生素治疗平均住院10d；11例脓肿平均直径11cm，采用抗生素联合经皮穿刺引流治疗，平均住院30d；4例最后进行了外科探查和肾切除。结论：肾周脓肿临床变化特点并不典型，CT检查是目前确诊最可靠的方法，通过明确的分期以获得理想的疗效。

Perinephric abscesses(Report of 25 cases)

Purpose:To study the diagnosis and treatment of perinephric abscess.Methods:Twenty five cases of perinephric abscess have been identified during the study period.Results:Of the 25 patients identified with perinephric abscesses 3(12%) ultimatedly died. Urine cultures were positive in 72%of patients and CT had a diagnostic sensitivity of 92%.Ten patients with a mean abscess size of 1.8cm.were treated with antibiotics alone (mean hospitalization 10days), while 11 with a mean abscess size of 11cm received antibiotics and initial percutaneous drainage (mean hospitalization 30 days). Of the 11 patients treated with percutaneous drainage 4 ultimately required surgical exploration and nephrectomy.Conclusions:The clinical characteristic of perinephric abscesses have not changed significantly but improve imaging with CT allows earlier diagnosis and accurate staging and careful followup,a variety of treatments can be successful.