Sood G, Sood A, Jindal A, Verma D K, Dhiman D S
Department of Surgery, Indira Gandhi Medical College Shimla H.P., India.
Int Braz J Urol. 2006 May-Jun;32(3):281-6. doi: 10.1590/s1677-55382006000300004.
Analyze the success rate, complications and overall benefit of ultrasound guided percutaneous nephrostomy (PCN) for the relief of obstructive uropathy in benign and malignant diseases.
PCN was performed in 50 kidneys of 32 patients. It was performed in emergency rooms totally under ultrasound guidance by general surgeons. Seldinger technique was used in all cases. Changes in renal function after the procedure were analyzed using paired t-test.
The procedure was successfully completed in 42 out of 50 kidneys (84%). There has been no major complication and 28% minor complications. The renal function improved significantly when PCN was performed for benign conditions (mean creatinine 3.52 mg/dL before and 2.18 mg/dL after PCN), however in malignancy there has been no significant improvement in renal function (before PCN mean creatinine 6.39 mg/dL and after PCN 5.41 mg/dL).
We conclude that PCN can be effectively performed under ultrasound guidance and should be the initial procedure in acutely obstructed kidneys with pyonephrosis and poor renal function. In malignant cases, however, improvement in renal function is possible only if the procedure is carried out at an early stage.
分析超声引导下经皮肾穿刺造瘘术（PCN）缓解良性和恶性疾病所致梗阻性肾病的成功率、并发症及总体效益。
对32例患者的50个肾脏进行了PCN。全部由普通外科医生在超声引导下于急诊室完成。所有病例均采用Seldinger技术。采用配对t检验分析术后肾功能变化。
50个肾脏中有42个（84%）手术成功完成。无严重并发症，轻微并发症发生率为28%。良性疾病行PCN后肾功能显著改善（PCN术前平均肌酐3.52mg/dL，术后2.18mg/dL），而恶性疾病患者肾功能无显著改善（PCN术前平均肌酐6.39mg/dL，术后5.41mg/dL）。
我们得出结论，PCN可在超声引导下有效实施，对于伴有肾积脓和肾功能较差的急性梗阻性肾脏，应作为首选治疗方法。然而，在恶性病例中，只有在疾病早期进行该手术，肾功能才有可能改善。
