Fernandez J A, Miles B J, Buck A S, Gibbons R P
Urology. 1985 Feb;25(2):142-4. doi: 10.1016/0090-4295(85)90530-8.
This article represents a retrospective study of 12 patients with renal carbuncle treated at the combined urological services of The Mason Clinic in Seattle, Washington, and Madigan Army Medical Center in Tacoma, Washington. All patients were initially treated with antibiotics. Two recovered without further treatment. Of the 10 patients who failed to respond, 2 underwent nephrectomy for nonfunctioning kidneys, 4 underwent closed percutaneous drainage, and 4 underwent surgical open drainage. All patients treated with open surgical drainage recovered and retained functioning kidneys. Of the 4 patients who underwent closed percutaneous drainage, 2 failed to respond and required subsequent emergency nephrectomy because of sepsis. The authors believe that renal exploration and open drainage should be the initial definitive mode of surgical treatment of renal carbuncle in those patients who fail antibiotic therapy alone.
本文是一项回顾性研究，研究对象为12例在华盛顿州西雅图市梅森诊所和华盛顿州塔科马市马迪根陆军医疗中心联合泌尿外科接受治疗的肾痈患者。所有患者最初均接受抗生素治疗。2例患者未经进一步治疗即康复。在10例无反应的患者中，2例因肾脏无功能而接受了肾切除术，4例接受了经皮闭式引流，4例接受了手术切开引流。所有接受手术切开引流的患者均康复且保留了有功能的肾脏。在4例接受经皮闭式引流的患者中，2例无反应，因败血症随后需要进行急诊肾切除术。作者认为，对于仅接受抗生素治疗无效的患者，肾脏探查和切开引流应作为肾痈外科治疗的初始确定性方式。
