Gelabert Mas A, Arango O, Bielsa O, Lladó C
Servicio de Urología, Hospital Universitari del Mar, Facultad de Medicina, Universitat Autónoma de Barcelona.
Actas Urol Esp. 1992 Jun;16(6):513-6.
The prevalence of renal and perinephritic abscesses has radically changed over the last few decades basically due to two causes: the efficacy of antibiotics and early diagnosis by echography and/or CAT. Between January 1986 and December 1990, 12 cases of renal abscesses have been diagnoses in our Unit which have been treated conservatively through therapy with antibiotics and lumbar percutaneous drainage. Only one case was resolved with antibiotics alone; all other 11 cases needed drainage, in spite of a improvement in the symptoms, which was performed by translumbar puncture. Drainage was effective in 10 cases and the cultures found 5 cases of E. coli, 4 cases of Staphylococcus aureus and 1 case of Gram(-) bacilli. In the two cases where percutaneous drainage was not effective abscesses were produced by fungi: C. albicans and Mucor mycosis which caused highly solid septum and sphacelus requiring in both cases the use of open surgery. Currently this disease no longer represents a serious problem, it has a minimal morbidity and no mortality; only the group of high risk immunosupressed patients (AIDS, HIV (+), ADVEP) shows an increase in the number of cases and management in these patients continues to be problematic.
在过去几十年间，肾脓肿和肾周脓肿的患病率发生了根本性变化，主要归因于两个原因：抗生素的疗效以及超声检查和/或计算机断层扫描（CAT）的早期诊断。1986年1月至1990年12月期间，我们科室诊断出12例肾脓肿病例，均通过抗生素治疗和经皮腰椎引流进行了保守治疗。仅1例单独使用抗生素后痊愈；尽管症状有所改善，但其余11例均需引流，通过经腰穿刺进行。10例引流有效，培养结果显示5例为大肠杆菌、4例为金黄色葡萄球菌、1例为革兰氏阴性杆菌。在2例经皮引流无效的病例中，脓肿由真菌引起：白色念珠菌和毛霉菌病，导致高度实性间隔和坏疽，这两例均需进行开放手术。目前，这种疾病不再是一个严重问题，发病率极低且无死亡率；只有高危免疫抑制患者群体（艾滋病、HIV阳性、晚期肾病患者）的病例数量有所增加，对这些患者的治疗仍然存在问题。
