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超声引导下经皮肾穿刺造瘘(PCN)管置入术:一项新技术的分步报告及其安全性和有效性评估

Ultrasound Guided Direct Percutaneous Nephrostomy (PCN) Tube Placement: Stepwise Report of a New Technique with Its Safety and Efficacy Evaluation.

作者信息

Lodh Bijit, Gupta Sandeep, Singh Akoijam Kaku, Sinam Rajendra Singh

机构信息

Postdoctoral (M.Ch. Trainee), Registrar, Department of Urology, Regional Institute of Medical Sciences (RIMS) , Imphal, Manipur, India .

Associate Professor, Department of Urology, Regional Institute of Medical Sciences (RIMS) , Imphal, Manipur, India .

出版信息

J Clin Diagn Res. 2014 Feb;8(2):84-7. doi: 10.7860/JCDR/2014/7216.4015. Epub 2014 Feb 3.

Abstract

AIMS

Ultrasound guided Percutaneous Nephrostomy (PCN) tube placement: evaluation, safety and efficacy review.

SETTINGS AND DESIGN

This was a quasi-experimental study conducted at Department of Urology, Regional Institute of Medical Sciences, Imphal.

MATERIALS AND METHODS

The total number of 176 patients with grade I-IV hydronephrosis requiring PCN tube placement were included in the study. Scientific, operational and accessory steps of the technique and its related safety and efficacy pre-procedural, intra-procedural and post-procedural parameters were carefully and meticulously recorded.

STATISTICAL ANALYSIS

Statistical analyses was performed using the Statistical Package for the Social Sciences (SPSS 16.0) for Windows.

RESULTS

The average length of the procedure was 9.07±2.79 (6-15) minutes. Severe procedure related pain (VAS score 8-10) was observed only in 18 patients (10.23%). Nephrostomy tube placement was successful in 96.60% of cases and only 9.66% required more than a single attempt of puncture. In this study, impacted ureteric calculus was found to be most common indication of PCN tube placement.

CONCLUSIONS

Ultrasound guided direct PCN tube placement is a reliable, easy and cost effective technique. This procedure is particularly suitable for developing countries like India, where the majority of the patients belongs to the low socio-economical status and health care system lacks adequate infrastructural facility at most places.

摘要

目的

超声引导下经皮肾造瘘(PCN)管置入术:评估、安全性及疗效回顾。

设置与设计

这是一项在英帕尔地区医学科学研究所泌尿外科进行的准实验研究。

材料与方法

本研究纳入了176例需要置入PCN管的I - IV级肾积水患者。对该技术的科学、操作及辅助步骤及其相关的术前、术中和术后的安全性和疗效参数进行了仔细且详尽的记录。

统计分析

使用适用于Windows的社会科学统计软件包(SPSS 16.0)进行统计分析。

结果

该操作的平均时长为9.07±2.79(6 - 15)分钟。仅18例患者(10.23%)出现了与操作相关的严重疼痛(视觉模拟评分8 - 10分)。肾造瘘管置入成功率为96.60%,仅9.66%的患者需要进行不止一次穿刺尝试。在本研究中,嵌顿性输尿管结石被发现是PCN管置入最常见的指征。

结论

超声引导下直接PCN管置入术是一种可靠、简便且经济有效的技术。该操作特别适用于像印度这样的发展中国家,在这些国家,大多数患者社会经济地位较低,且大多数地方的医疗保健系统缺乏足够的基础设施。

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