目的 比较超声引导下经窦道顺行导管法和经导管顺行导丝法更换肾造瘘管的效果。方法 回顾性分析2014-01至2025-03在解放军总医院第一医学中心更换肾造瘘管患者的临床资料,比较超声引导下经窦道顺行导管法和经导管顺行导丝法更换肾造瘘管的临床效果。结果 204例患者共进行了529例次肾造瘘管更换治疗。319例次使用经窦道顺行导管法,其中2例次出现轻度出血,3例次出现寒战发热,6例次换管失败,换管成功率98.12%;210例次使用经导管顺行导丝法,其中2例次出现术后出血,1例次出现寒战发热,21例次换管失败,换管成功率90.00%。结论 经窦道顺行导管法比经导管顺行导丝法手术时间更短,疼痛感更轻,成功率更高,在窦道已形成的条件下,可作为更换造瘘管的首选方式。
Abstract
Objective To compare the application effects of antegrade catheterization through sinus tract and antegrade guidewire through catheter in nephrostomy tube exchange. Methods The clinical data of patients who underwent nephrostomy tube exchange in the First Medical Center of PLA General Hospital from January 2014 to March 2025 were retrospectively analyzed. The clinical effects of ultrasound-guided antegrade catheterization through sinus tract and antegrade guidewire through catheter in nephrostomy tube exchange were compared. Results A total of 529 cases of nephrostomy tube exchange treatment were performed on 204 patients. Among them, 319 cases were conducted via antegrade catheterization through sinus tract, with 2 cases of mild bleeding, 3 cases of chills and fever, and 6 cases of exchange failure, achieving a success rate of 98.12%; a total of 210 exchanges were performed via antegrade guidewire through catheter, with 2 cases of postoperative bleeding, 1 case of chills and fever, and 21 cases of exchange failure, achieving a success rate of 90.00%. Conclusions Compared with antegrade guidewire through catheter, antegrade catheterization through sinus tract is characterized by shorter operation time, less pain and higher success rate. When the sinus tract has already been formed, it can be used as the preferred method for clinical nephrostomy tube exchange.
关键词
经皮肾穿刺造瘘术 /
造瘘管 /
同轴导丝法 /
超声引导
Key words
percutaneous nephrostomy /
fistulization tube /
coaxial downstream guidewire method /
ultrasound guidance
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