肾造口术(nephrostomy)和尿道造口术(urostomy)的区别

在分析肾造口术和尿路造口术的区别之前，让我们先看看“造口”一词的含义。气孔是连接体腔和外部环境的一个开口，无论是自然的还是外科的。肾造口术是在肾脏和背部皮肤之间人工**的一个开口，它允许直接从泌尿系统上部（肾盂）分流（尿液通过正常的输尿管通道流动）。尿路吻合术是一种类似的手术，沿着泌尿系统（通常是从膀胱）远端进行，以提供尿路分流。在膀胱和尿道无法排出尿液的情况下，例如在梗阻的情况下，可以进行尿路吻合术，用于尿流改道。肾造瘘和尿路吻合术的关键区别在于，肾造瘘术是在肾盂和背部皮肤之间进行的，而造瘘术是在膀胱/输尿管下段和下腹部皮肤之间进行的。然而，尿路造口术有时指的是尿路与外部的任何连接，包括肾造口。

什么是肾造口术(nephrostomy)？

Nephrostomy is an artificial connection between the upper part of the urinary tract and the skin on the back created surgically to facilitate the flow of urine in the presence of a distal obstruction to the urinary tract. Generally, a hole is created under anesthesia using surgical instruments. Then the hole is enlarged using dilators. This is done under ultrasonic guidance. Then a pigtail catheter is inserted between the renal pelvis and the exterior. This will allow free flow of urine by passing a distal obstruction. The external end of the catheter is usually connected to a collecting bag. This procedure is done in the case of urinary stone disease, which causes complete obstruction or renal abscess, a malignancy causing ureteric obstructi***. This procedure helps to protect the remaining renal tissue from further damage. This is usually done as an emergency procedure. Once the distal obstruction is relieved, the nephrostomy can be removed. Common complicati*** of the procedure are accidental renal puncture causing lot of bleeding, rupture of the renal pelvis and the displacement and blockage of the pigtail catheter. Patency of the catheter can be tested by a die test which is usual in the case of obstructi***.

什么是尿道造口术(urostomy)？

Urostomy is usually created between the urinary bladder or lower ureters and the skin on the lower abdomen. This procedure is quite different, and the ureters are directly opened to the outside or part of the bowel is used to create the stoma. Then the stoma is covered with a collecting bag. Sometimes an internal pouch is surgically created to collect urine using a part of the bowel when the bladder is removed during the surgery such as in bladder carcinoma. This procedure is done in situati*** like infiltrating prostatic or bladder carcinoma, urethral injury. Complicati*** of the procedure include bladder injury and cystitis.

肾造口术(nephrostomy)和尿道造口术(urostomy)的区别

肾造瘘和尿路造瘘的特点：

解剖：

肾造口术：肾造口术是在肾盂和背部皮肤之间形成的。

尿路吻合术：在膀胱/输尿管下段和下腹部皮肤之间造瘘。

使用的导管：

肾造口术：猪尾管用于尿路引流。

尿路吻合术：输尿管远端或肠的一部分与皮肤缝合形成造口。

难题：

肾造口术：肾造口术会导致意外的肾穿刺出血、肾盂破裂、猪尾管移位堵塞。

尿道吻合术：尿道吻合术会导致内脏**损伤和感染、*****和皮肤相关并发症，如瘙痒。

目的：

肾造口术：肾造口术是为了缓解上尿路梗阻，如结石引起的完全梗阻或肾脓肿，恶性肿瘤引起的尿路梗阻。