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膀胱上尿路改道最常用的方法是将输尿管吻合到一游离的回肠段上,然后通过皮肤造口进行排尿。但此种方法常常并发皮肤回肠造口部和输尿管回肠吻合的狭窄。由于狭窄引起上尿路梗阻,常需要手术治疗,但是这些病人很可能并发有感染、氮血症,使手术不易进行。作者应用经皮肾造口顺行性导管引流的方法对4例有造口部和输尿管回肠吻合部狭窄的病人进行了成功的肾盂肾盏的减压,改善了肾功能。其方法为:于腋后线12肋骨下缘部位进行穿刺,在荧光透视下将French 5号带芯套管针刺入肾盂内,将管芯退出,插入导丝,当导丝达到远端输尿管时,则将套管换成较长的6.3French直形血管造影导管,这样可以使导丝容易通过吻合口和回
The most common method of diverting the urinary bladder to the upper urinary tract is to anastomose the ureter to a free ileum segment and then urinate through the skin ostomy. However, this method is often complicated by ileostomy and ureteral ileal anastomosis stenosis. Due to stricture caused by upper urinary tract obstruction, often require surgical treatment, but these patients are likely to be complicated by infection, azotemia, so that surgery is not easy. The authors applied the method of percutaneous nephrostomy with cisternal catheter drainage to successfully decompress the renal pelvis and calyceal in 4 patients with stenosis of the ostomy and ureteral anastomosis and improve renal function. The method includes: puncturing the lower edge of the rib 12 in the posterior axillae, puncturing French 5 trocar into the renal pelvis under fluoroscopy, withdrawing the die, inserting the guide wire, inserting the guidewire into the distal ureter , The cannula is replaced by a longer 6.3 French angiography catheter which allows the guidewire to pass easily through the anastomosis and back