The Clinical Value Of Ultrasound Guided Percutaneous Nephrostomy For Obstructive Acute Renal Failure

Objectives To explore the technical analysis and clinical application of ultrasound guided percutaneous nephrostomy in the treatment of obstructive acute renal failure.Methods From September 2019 to September 2021,93 patients with obstructive acute renal failure diagnosed in Tangshan workers’hospital and treated with ultrasound guided PCN and transurethral ureteroscopy were selected for retrospective analysis.42patients with ultrasound guided percutaneous nephrostomy were included in the observation group and 51 patients with transurethral ureteroscopy as the control group.Collect the general information of the research object.Serum creatinine,urea nitrogen and urine volume were recorded before and after treatment;the treatment cost,intraoperative bleeding,operation time and hospital stay of the two groups were recorded;the occurrence of postoperative adverse reactions was recorded;the abnormalities of drainage tube after operation were recorded;record the time when all indexes return to normal after operation;record the surgical results;the interval time,operation time and cost of regular replacement of drainage tube after operation were recorded.Application of SPSS 22.0 software statistical analysis.The measurement data of normal distribution were expressed with（x±s）,the measurement data of non normal distribution were expressed by median and quartile[M(P₂₅,P₇₅)],and the hypothesis test adopts independent sample t test,paired t test and Rank Sum test;count data and grade data were expressed by frequency or rate（%）,and Chi-square test and Rank Sum test were used for comparison between groups.P<0.05 was statistically significant.Results 1 Operation:the operation time of the observation group was shorter than that of the control group,and the difference was statistically significant（t=-3.100,P=0.003）;the treatment cost of the observation group was lower than that of the control group,and the difference was statistically significant（t=-6.790,P<0.001）.2 Surgical results:among the93 operations,42 cases were successful and 0 cases failed in the observation group,with a success rate of 100.00%,while 45 cases were successful and 6 cases failed in the control group,regarding a success ratio of 88.24%,and the difference was statistically significant（P=0.031）.3 Recovery of all indexes after operation:among the patients successfully cured in the two groups,the time for the recovery of postoperative body temperature in the observation group was（2.36±1.01）d,and the time for the recovery of postoperative body temperature in the control group was（3.15±0.90）d.After the statistics of body temperature measurement,the recovery time of the observation group was earlier than that of the control group,and the difference was statistically significant（t=-2.160,P=0.040）.4 Postoperative drainage tube abnormalities,13 and 6 patients in the observation group and the control group had blockage,displacement or prolapse of drainage tube respectively.The incidence of drainage tube prolapse in the observation group was bigger than them in the control group,and the total incidence was 30.94%and 13.33%respectively（χ²=5.674,P=0.017）.5 Postoperative replacement of drainage tube:the operation time of the observation group was shorter than that of the control group,and the difference was statistically significant（t=-2.314,P=0.028）;the cost of tube replacement treatment in the observation group was lower than that in the control group,and the difference was statistically significant（t=-2.326,P=0.027）.Conclusions 1 Ultrasound guided percutaneous nephrostomy in the treatment of obstructive acute renal failure has the advantages of short operation time and low cost.It can be completed by simply replacing the drainage tube regularly in the outpatient department without hospitalization.2 Ultrasound guided percutaneous nephrostomy is more effective than other treatment methods in the treatment of obstructive acute renal failure with inflammatory change or purulent change of urinary system.3 Ultrasound guided percutaneous nephrostomy in the treatment of obstructive acute renal failure has the advantages of simple operation,timely removal of obstruction and drainage of urine,and low incidence of complications.4 Ultrasound guided percutaneous nephrostomy is efficient,safe and widely used in the treatment of obstructive acute renal failure.Figure 4;Table12;Reference111...