小儿多发性上尿路结石梗阻致急性肾功能衰竭的诊断及早期处理

目的：提高小儿上尿路多发性结石的诊断及早期治疗水平。方法：回顾性分析32例小儿上尿路多发性结石致急性肾功能衰竭的诊断及早期治疗过程,总结出较好的早期诊断与治疗的方法。结果：32例患者经腹部平片(KUB)及B超检查确诊27例,5例另行CT检查而确诊,32例患者均急诊处理,其中5例行输尿管镜碎石、4例经小儿膀胱镜置人小儿双J管而解除梗阻,23例经小儿膀胱镜置小儿双J管失败后,经常规手术解除梗阻,术后肾功能恢复良好。结论：小儿上尿路多发性结石致急性肾功能衰竭须早期诊断及治疗,KUB及B超检色是较好的诊断方法,应以简单、有效、创伤小的方法解除梗阻,可光用内镜方法治疗,如失败,则应急行常规手术解除梗阻。结石可留作Ⅱ期处理。

Diagnosis and treatment of the acute renal failure that caused by upper urinary Lithiasis obstruction in children

Purpose:To improve the level of the diagnosid and treatment of the acute renal failure resulted from obstruction of upper urinary multiple lithiasis in children.Methods:To retrospectiveiy analyze 32 cases of acute renal failure caused by upper urinary multiple lithiasis obstruction in children.Results:In these 32 cases,27 patients were diagnosed by KUB X ray and B ultrasonic, and 5 patients through CT scan. There were 5 patients' obstruction were relieved through endoscope's way, 4 patients by posting Double J catheter, whereas 23 cases by operation. All the renal function resumed well after treatment.Conclusions:KUB X ray and B ultrasonic are good ways for diagnosing the obstruction of upper urinary resulted from multiple lithiasis. Obstruction should be relieved by the efficient, less wound and simple way. Operation can be used when Endoscope is unsuccessful.