摘要
目的:探讨平卧位经皮肾穿刺造瘘术(percutaneous nephrostomy,PCN)并发结肠损伤的几率,为临床应用PCN提供参考。方法:对432例平卧位腹部CT扫描片进行分析,模拟自腰椎前切缘分别经过肾上极、肾门、肾下极的穿刺线,将结肠位置分为穿刺线前、线后或经过穿刺线,前者定义为无潜在损伤风险,后两者定义为有潜在损伤风险,从影像学分析平卧位PCN并发结肠损伤的几率。结果:平卧位经左侧肾上极、肾门、肾下极的穿刺中结肠有潜在损伤风险的几率分别为0、0、0.7%(3/432);经右侧肾上极、肾门、肾下极的穿刺中无1例有潜在损伤风险。结论:采用平卧位行PCN并发结肠损伤几率低,PCN术前常规做CT扫描检查,了解腹部内脏解剖位置关系可避免发生结肠损伤等严重并发症。
Objective： To study the risk probability of colon inju by percutaHeous nephrostomy （PCN） in supine position, and to provide reference for PCN. Methods. A series of 432 supine abdominal computed tomography （CT） scans ,were analyzed. A line of PCN from the anterior margin of the lumbar vertebra to the upper pole, or hilum, or lower pole of the kidney was simulated. From an anatomic point view, if the colon was located anterior to the line or on the line of the PCN, it represented a potential risk of colon injury. If the colon was located posterior to the line, it represented no potential risk of colon injyrt The risk probability of colon injury by PCN in supine position was analyzed. Results： The potential risk of colon injury by PCN in supine position from the upper pole, or hilum, or lower pole of the left kidney was 0, 0 and 0. 7% （3/432） respectively, while the potential risk of coloH injury, was 0 when the right kidney was punctured. Conclusion： The potential risk of colon injuu＇ by PCN in supine position is extremely small. CT scan should be performed to identify the unusual anatomy before PCN to avoid happening of colon injury.
出处
《新医学》
北大核心
2007年第11期714-715,720,F0003,共4页
Journal of New Medicine
基金
广东佛山市科研立项项目(2007390)
