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[梗阻性肾衰竭中的经皮肾造瘘术并发症]

[Percutaneous nephrostomy complications in obstructive renal failure].

作者信息

Ristescu C, Costache C, Suditu N, Ciută C

机构信息

Clinica de Urologie Si Transplant Renal, Universitatea de Medicină şi Farmacie Gr. T. Popa Iaşi Facultatea de Medicină.

出版信息

Rev Med Chir Soc Med Nat Iasi. 2011 Apr-Jun;115(2):428-33.

Abstract

OBJECTIVES

The study aimed to identify the complications recorded at the patients with obstructive renal failure treated with percutaneous nephrostomy (PCN).

MATERIAL AND METHOD

The retrospective study investigated the data of 244 patients admitted in our department and treated with percutaneous nephrostomy for obstructive renal failure during January 2005 - December 2007. Demographical data, investigation, indication, complications and hospital stay were recorded.

RESULTS

Median preoperative/discharge haematological values were hematocrit 27.4% comparing to 25.8% and haemoglobin 9.9g% comparing to 9.3g%. An anaemic syndrome was noted at admission time in 161 (65.9%) patients and at discharge time 202 (82.8%). 126 (51.6%) patients were treated with blood transfusion with an average dose of 2.47 red blood cell units per patient. In 25 (10.1%) patients the nefrostomy tube was clamped in order to control the postoperative bleeding. The median hospitalization time was 8.7 days with a median ICU stay of 3.3 days. The recorded mortality was 3.2% (8 patients) with an average time of 5.8 days between the operatory time and exitus time.

CONCLUSIONS

The most frequent causes of obstructive renal failure necessiting percutaneous nephrostomy are malignancies. Preoperative anaemic syndrome is aggravated in the postoperative period and frequently need red blood cell administration. In experienced hands, PCN catheter placement is safe and usually successful.

摘要

目的

本研究旨在确定经皮肾造瘘术(PCN)治疗梗阻性肾衰竭患者时记录的并发症。

材料与方法

这项回顾性研究调查了2005年1月至2007年12月期间在我科接受经皮肾造瘘术治疗梗阻性肾衰竭的244例患者的数据。记录了人口统计学数据、检查、适应症、并发症和住院时间。

结果

术前/出院时血液学指标的中位数分别为:血细胞比容27.4%(术前)对比25.8%(出院时),血红蛋白9.9g%(术前)对比9.3g%(出院时)。161例(65.9%)患者入院时存在贫血综合征,202例(82.8%)患者出院时存在贫血综合征。126例(51.6%)患者接受了输血治疗,平均每位患者输注2.47个红细胞单位。25例(10.1%)患者为控制术后出血而夹闭肾造瘘管。中位住院时间为8.7天,中位重症监护病房停留时间为3.3天。记录的死亡率为3.2%(8例患者),手术时间至死亡时间的平均间隔为5.8天。

结论

需要进行经皮肾造瘘术的梗阻性肾衰竭最常见原因是恶性肿瘤。术前贫血综合征在术后加重,经常需要输注红细胞。在经验丰富的医生操作下,经皮肾造瘘管置入是安全的,且通常成功。

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