經皮腎造瘻術－176例經驗報告

Percutaneous Nephrostomy-176 Cases Experience

邱昭彥(Chau-Yan Chiou) ； 黃明和(Min-Huo Hwang)

《中華放射線醫學雜誌》 10卷2期 (1985/06) Pp. 131-137

摘要

1955年Goodwin在腎盂積水的病人引用了經皮腎造瘻術(PCN)作暫時的尿液引流，如今儀器（超音波、電腦斷層攝影）以及技術與材料的配合發展，更使經皮腎造瘧術被廣泛應用，對尿路阻塞之暫時減壓或尿液引流成為一快速、直接又相當安全的方法。最近這種方法更積極的被應用在(1)治療尿路阻塞合併菌血症(2)阻塞性之腎功能的恢復與保存(3)腎臟輸尿管結石之溶石與取石(4)輸尿管或腎盂狹窄之擴張(5)放置輸尿管內管(stent placement)(6)輸尿管瘻管之阻塞治療。秀傳紀念醫院自民國73年5月至12月八個月間因(1)腎臟、輸尿管結石施行超音波碎石取石術(2)為保存腎功能(3)手術後輸尿管洩漏或狹窄擴張等而作經皮腎造瘻術者有176例。本院採用(Seldinger)血管攝影術在超音波與X光透視引導下完成經皮腎造瘻術，成功率達97.5%。以超音波碎石取石為最多有163例，其他14例是為保存腎功能……等，皆無嚴重併發症。施行PCN的適應症，技術方法與經驗將提出討論。

並列摘要

From May to December 1984, 176 patients have received the PCN in Show-Chwan Memorial Hospital for (1) ultrasonic lithotripsy for stone removal (2) preservation of renal function to obstructed lower ureter by pelvic neoplasm (3) correction of ureteral leakage or ureteral fistula and (4) stricture dilatation. There were 120 male and 56 female, age between 20 to 74 years old (mean 44.4)
Under the fluoroscopic and ultrasonic guidance, we used the angiographic (Seldinger) technique to place 8-12 F preformed curve or pigtail multiside holes polyethylene catheter into renal calyx, pelvis, or upper ureter. The successful rate is 97.5%. Stone retrieval by ultrasonic lithotripsy for 163 cases, 14 cases. for preserved renal function.. .etc. No serious complication is encountered. The indications, technique, and experience of PCN are discussed.