上尿路结石梗阻性急性肾功能衰竭的微创治疗(附42例报告)

Microtraumatic treatment of obstructive renal dysfunction caused by upper urinary stones(Report of 42 cases)

关键词:  微创  梗阻性肾功能衰竭  上尿路结石

Key words:  microtraumatic  obstructive renal dysfunction  upper urinary stone

摘要:

［目的］ 探讨上尿路结石梗阻性急性肾功能衰竭的微创治疗方法。［方法］2002年3月~2008年1月，对42例上尿路结石梗阻性急性肾功能衰竭患者中，11例因严重急性肾衰先行血液透析治疗1~2次，然后根据具体病情不同，分别行输尿管镜下气压弹道碎石术、经皮肾穿刺造瘘术、经皮肾镜碎石术及ESWL等微创方法治疗。［结果］42例患者均成功解除尿路梗阻，无一例死亡。住院时间3～23 d，平均7.5 d。术后1个月肾功能恢复正常者36例；6例仍有氮质血症,但肾功能明显改善。［结论］微创技术在治疗上尿路结石梗阻性急性肾功能衰竭方面具有创伤小、病人易耐受、安全性好的特点,可根据病人的具体情况选择采用不同的微创治疗方法。

Abstract:

［Objective］To explore the microtraumatic treatment for Acute obstructive renal dysfunction(AORF) caused by upper urinary stones.［Methods］According to specific patient's conditions, 42 cases with AORF respectively received ureteroscopic pneumatic lithotripsy, percutaneous nephrostomy(PCN) , percutaneous nephrolithotomy(PCNL) and extracorporeal shock wave lithotripsy ( ESWL).［Results］All of the patients were treated successfully , no death. The hospitalization time was 3～23 d (mean, 7.5 d). Renal functions recovered to normal within 1 months after operation in 36 cases; different degrees of azotemia remained within 1 month after operation in 6 cases, their renal functions were improved significantly.［Conclusions］Microtraumatic treatment has advantages of minimal trauma, good tolerance of patients, and satisfactory safety for treating AORF caused by upper urinary stones. Different microtraumatic methods can be selected according to patient’s condition.