Higashi Y, Oishi K, Hida S, Nishimura M, Kihara Y, Takenawa J, Tanaka H, Kawamura J, Yoshida O
Hinyokika Kiyo. 1985 Nov;31(11):1907-18.
Ultrasound guided percutaneous nephrostomy (PNS) was performed on 72 patients (80 kidneys) including pretreatment for percutaneous nephro-uretero lithotomy (PNL). PNS was performed for post-renal anuria or hydronephrosis in 23 cases (28 kidneys), for urinary leakage in 4 cases (5 kidneys), for vesical bleeding in 1 case (2 kidneys) and as pretreatment of PNL in 44 cases (45 kidneys). Ultrasound guided renal puncture was done percutaneously and a 0.038 inch J-tipped wire guide was inserted into the suitable calyx. Then the nephrostomy tract was dilated with fascia dilators of Malecot nephrostomy set. A 14 Fr or 16 Fr Malecot catheter was used for hydronephrosis or urinary leakage cases. 18 Fr, 24 Fr Malecot catheter or Bardex balloon catheter 18-22 Fr was inserted for PNL cases. In the PNL group, Ht decreased slightly but there was no need of blood transfusion. In the other groups, Ht did not change. Defect of 99m-Tc-DMSA renal uptake in several cases suggested renal injury at nephrostomied cortex. In about 70% of the cases, a fever of more than 37 degrees C was observed, and in 4 cases, more than 39 degrees C was observed. There were no major complications observed. In conclusion, percutaneous nephrostomy using Malecot nephrostomy set is a safe and effective method.
对72例患者（80个肾脏）实施了超声引导下经皮肾造瘘术（PNS），其中包括经皮肾输尿管取石术（PNL）的术前准备。23例（28个肾脏）因肾后性无尿或肾积水进行PNS，4例（5个肾脏）因尿漏进行PNS，1例（2个肾脏）因膀胱出血进行PNS，44例（45个肾脏）作为PNL的术前准备。经皮在超声引导下进行肾穿刺，并将一根0.038英寸的J形头导丝插入合适的肾盏。然后用麦氏肾造瘘套装的筋膜扩张器扩张肾造瘘通道。肾积水或尿漏病例使用14F或16F的麦氏导管。PNL病例插入18F、24F的麦氏导管或18 - 22F的巴德克斯球囊导管。在PNL组中，血细胞比容（Ht）略有下降，但无需输血。在其他组中，Ht没有变化。几例患者99m锝 - 二巯基丁二酸（99m-Tc-DMSA）肾摄取缺陷提示肾造瘘皮质有肾损伤。约70%的病例观察到体温超过37摄氏度，4例体温超过39摄氏度。未观察到严重并发症。总之，使用麦氏肾造瘘套装进行经皮肾造瘘术是一种安全有效的方法。
