Loran O B, Siniakova L A, Bernikov E V
Urologiia. 2008 Sep-Oct(5):3-7.
The kidneys of the patients with purulent pyelonephritis (PP) undergo anatomic and functional alterations. The latter may be irreversible in some cases. The severity of the above alterations depends on PP form, choice and time of treatment. Our study included 84 patients who had PP at the age of 15 to 70 years. Primary PP was detected in 47 (56%) patients, secondary--in 37 (44%) patients. Open surgery was performed in 18 patients (group 1), transcutaneous drainage was used in 38 patients (group 2), conservative treatment was conducted in 28 patients (group 3). Comparison of dynamic nephroscintigraphic findings showed that recovery of renal function in groups 2 and 3 lasted 6-12 months versus 60-84 months in group 1. The degree of the renal function recovery depends on the PP form, age of the patient, duration of the disease, virulence of the causing agent, comorbid pathology, immune status, method of treatment. This was confirmed by the data of complex radionuclide examination. Long term complications, for instance, progress of arterial hypertension (41% cases) and chronic pyelonephritis (44% cases) were observed more frequently and earlier in patients after open operations.
化脓性肾盂肾炎（PP）患者的肾脏会发生解剖学和功能上的改变。在某些情况下，后者可能是不可逆的。上述改变的严重程度取决于PP的类型、治疗方法及治疗时机。我们的研究纳入了84例年龄在15至70岁的PP患者。其中47例（56%）为原发性PP，37例（44%）为继发性PP。18例患者接受了开放手术（第1组），38例患者采用了经皮引流（第2组），28例患者进行了保守治疗（第3组）。动态肾闪烁显像结果比较显示，第2组和第3组肾功能恢复持续6至12个月，而第1组为60至84个月。肾功能恢复程度取决于PP类型、患者年龄、病程、致病病原体的毒力、合并的病理情况、免疫状态及治疗方法。这一点得到了放射性核素综合检查数据的证实。开放性手术后的患者更频繁且更早地出现长期并发症，例如动脉高血压进展（41%的病例）和慢性肾盂肾炎（44%的病例）。
