St Lezin M, Hofmann R, Stoller M L
Department of Urology, University of California School of Medicine, San Francisco.
Br J Urol. 1992 Oct;70(4):360-3. doi: 10.1111/j.1464-410x.1992.tb15788.x.
A series of 23 confirmed cases of pyonephrosis initially treated by percutaneous nephrostomy drainage were reviewed. Presentation was extremely variable, ranging from sepsis to asymptomatic bacteriuria. Fever, flank pain and leukocytosis were often absent. Ultrasonography was diagnostic in only 3 of 12 patients. In all, 17 patients had associated nephrolithiasis, and 5 patients ultimately required nephrectomy. Renal urine cultures were positive in 16 of 21 instances, with multiple organisms found in 8 of 21, and added bacteriological data not provided by bladder urine cultures in 11 cases. A pre-existing history of urinary tract infection, hypertension and malignancy was common. Percutaneous drainage was a safe, quick and effective diagnostic and therapeutic method.
回顾了一系列最初采用经皮肾造瘘引流术治疗的23例确诊肾盂积脓病例。临床表现差异极大，从脓毒症到无症状菌尿症不等。发热、胁腹疼痛和白细胞增多症往往并不存在。超声检查仅对12例患者中的3例具有诊断价值。总共有17例患者伴有肾结石，5例患者最终需要进行肾切除术。21例中有16例肾尿培养呈阳性，21例中有8例发现多种微生物，11例补充了膀胱尿培养未提供的细菌学数据。既往有尿路感染、高血压和恶性肿瘤病史很常见。经皮引流是一种安全、快速且有效的诊断和治疗方法。
