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目的:探讨CT导向下肾盂造瘘术的临床应用价值。方法:回顾性分析了21例输尿管梗阻而CT导向下行肾盂造瘘的病例,通过带有金属针鞘和穿刺针的引流管直接穿刺扩张的肾盂行肾盂造瘘。结果:21例患者,单侧置管造瘘19例,双侧置管造瘘2例,共置管23根,肾盂扩张>2.5cm的为20个,≤2.5cm为3个,1次性穿刺成功为19根,均为扩张肾盂>2.5cm,1次穿刺成功率为86.9%。2次穿刺成功3根,1根为扩张肾盂>2.5cm。3次穿刺成功1根,扩张肾盂≤2.5cm。引流管其侧孔均位于肾盂内,其并发症肾包膜下出血2例。术后随访3个月,19例单侧置管造瘘中引流管通畅的为15例,2例于1个月后滑落,2例阻塞。2例双侧引流3根引流管通畅,1根引流管阻塞。结论:CT导向下肾盂造瘘术安全,有效,对于结石、炎症、肿瘤、后腹膜纤维化、创伤所引起的肾盂扩张可起到姑息性治疗作用。
Objective: To evaluate the clinical value of pyelostomy guided by CT. Methods: A retrospective analysis of 21 cases of ureteral obstruction and CT guided downstream pyelolithotomy cases, through the drainage tube with a metal needle sheath and puncture needle directly puncture the dilated renal pelvis fistula. RESULTS: Twenty-one patients had unilateral catheterization in 19 cases, bilateral catheterization in 2 cases, co-catheterization in 23 cases, dilatation of renal pelvis> 2.5 cm in 20 cases, ≤2.5 cm in 3 cases and 1-time Puncture success was 19, both expansion dilatation of renal pelvis> 2.5cm, 1 puncture success rate was 86.9%. 3 successful puncture 2, 1 for the expansion of renal pelvis> 2.5cm. 3 successful puncture 1, expansion of renal pelvis ≤ 2.5cm. Drainage tube side holes are located in the renal pelvis, the complications of renal capsule hemorrhage in 2 cases. After 3 months of follow-up, there were 15 cases of drainage tube unilateral in 19 cases of unilateral catheterization, 2 cases slipped after 1 month and 2 cases blocked. 2 cases of bilateral drainage of three drainage patency, a drainage tube obstruction. CONCLUSION: CT-guided pyeloplasty is safe and effective and can play a palliative therapeutic role in pyelonephrosis caused by stones, inflammation, tumors, retroperitoneal fibrosis and trauma.