Derouiche A, Ouni A, Agrebi A, Slama A, Ben Slama M R, Chebil M
Service d'urologie, hôpital Charles-Nicolle, boulevard 9-Avril, 1006 Tunis, Tunisie.
Prog Urol. 2008 Feb;18(2):102-7. doi: 10.1016/j.purol.2007.08.002. Epub 2008 Mar 11.
To define the clinical, laboratory and morphological features of emphysematous pyelonephritis, as well as the treatment modalities, with particular emphasis on the need for urgent treatment.
Between 1987 and 2004, 21 patients were treated for emphysematous pyelonephritis. Epidemiological, clinical, laboratory and radiological data, treatments and clinical outcome were retrospectively collected for all patients.
This series comprised 15 women and six men with a mean age of 54.6 years. All were diabetic. Upper urinary tract obstruction was demonstrated in 47.6% of cases. The left kidney was affected in 14 patients and the right kidney was affected in six patients. Only one patient had bilateral pyelonephritis. The diagnosis was established by CT in every case. All patients received appropriate intensive care. Treatment was purely medical in one case. Emergency nephrectomy was performed in 12 patients, emergency surgical drainage was performed in three patients, percutaneous drainage was performed in two cases and ureteric catheter drainage was performed in three patients. The mortality rate in this series was 23.8%.
Emphysematous pyelonephritis is a serious infection. Early diagnosis is essential, particularly in diabetic patients. The positive diagnosis is based on computed tomography and treatment is now increasingly conservative.
明确气肿性肾盂肾炎的临床、实验室及形态学特征，以及治疗方式，尤其强调紧急治疗的必要性。
1987年至2004年间，21例气肿性肾盂肾炎患者接受了治疗。回顾性收集了所有患者的流行病学、临床、实验室及放射学数据、治疗方法及临床结局。
该系列包括15名女性和6名男性，平均年龄54.6岁。所有患者均患有糖尿病。47.6%的病例显示上尿路梗阻。14例患者左侧肾脏受累，6例患者右侧肾脏受累。仅1例患者患有双侧肾盂肾炎。所有病例均通过CT确诊。所有患者均接受了适当的重症监护。1例患者仅接受药物治疗。12例患者接受了急诊肾切除术，3例患者接受了急诊手术引流，2例患者接受了经皮引流，3例患者接受了输尿管导管引流。该系列的死亡率为23.8%。
气肿性肾盂肾炎是一种严重感染。早期诊断至关重要，尤其是在糖尿病患者中。阳性诊断基于计算机断层扫描，且治疗现在越来越趋于保守。
