超声引导下经皮肾造瘘穿刺方法的应用体会

目的评价超声引导下两种经皮肾盂穿刺造瘘方法的临床应用效果。方法111例患者的134个肾盂扩张肾脏,在超声引导下随机用“一步法”或“两步法”行经皮肾盂穿刺造瘘术。结果对肾盂分离≤2.5cm者,“两步法”穿刺造瘘的一次穿刺成功率（96%）高于“一步法”（72%,P〈0.05）,而肾盂分离〉2.5cm者两种方法一次穿刺成功率无差异。“一步法”与“两步法”经皮肾盂穿刺造瘘术在术后血尿、肾周出血、发热、管腔阻塞等并发症发生率方面无显著差异。结论对肾盂轻度扩张患者,采用“两步法”经皮肾盂穿刺造瘘术可获得更高的一次穿刺成功率。

Comparing study of two methods of ultrasound-guided percutaneous nephrostomy

Objective To Compare the clinical efficacy of two methods of ultrasound-guided percutaneous nephrostomy.Methods One hundred and eleven patients with 134 hydronephrotic kidneys underwent ultrasound-guided percutaneous nephrostomy.Results Pelviectasis under 2.5 cm,the primary technical success rate in "two-step"group was significantly higher than that in "one-step" group(96% vs 72%,P<0.05).Pelviectasis above 2.5 cm,there was no significant difference of the primary technical success rate between "one-step" and "two-step" group.There was no significant difference of the complication rate,including haematuria,haemorrhage around kidney,pyrexia,tube complications,between the two groups.Conclusion For the patients with mild pelviectasis,"two-step" percutaneous nephrostomy has a higher primary technical success rate than that of "one-step".