上尿路结石致急性肾后性肾功能衰竭的诊治

目的：研究经皮肾镜钬激光碎石术、双定位体外碎石术两种手术治疗上尿路结石致急性肾后性肾功能衰竭的临床疗效。方法：选择双侧上尿路结石致急性肾后性肾功能衰竭患者94例，随机分为观察组和对照组，各47例，在给予血液透析、抗感染的一般处理后，观察组给予经皮肾镜钬激光碎石术，对照组给予双定位体外碎石术治疗，比较两组尿量及肾功能恢复正常时间、治疗前后的血肌酐及尿素氮。结果：两组治疗后血肌酐、尿素氮均较治疗前明显降低，差异具有统计学意义（P〈0．05）；治疗前后血肌酐、尿素氮均无明显差别，差异无统计学意义（P〉0．05）。观察组术后尿量及肾功能恢复时间分别为（6．38±2．32）、（6．14±2．41）d，对照组分别为（6．53±2．74）、（6．23±2．59）d。两组术后尿量及肾功能恢复时间比较，差异无统计学意义（P〉0．05）。结论：经皮肾镜钬激光碎石术及双定位体外碎石术两种手术用于治疗上尿路结石致急性肾后性肾功能衰竭时，均可获得较好的临床疗效，且手术效果及起效时间基本相同。

Diagnosis and treatment of acute renal failure caused by upper urinary calculi

Objective： To investigate the curative effects of transurethral holmium laser lithotrip- sy, double positioning extracorporeal shock wave lithotripsy in the treatment of upper urinary tract stones with acute renal failure. Method：A total of 94 cases of acute renal failure caused by upper urinary tract calculi were selected. They were randomly divided into observation group and control group with 47 cases in each group. After the general treatment of hemodialysis and anti infection, the patients in the observa- tion group were treated with transurethral holmium. YAG laser lithotripsy, patients in control group were treated with double positioning extracorporeal shock wave lithotripsy, the renal function of two groups ofpatients before and after restoration of blood creatinine and urea nitrogen in normal time were compared. Results. The blood creatinine, urea nitrogen levels were significantly lower than that before treatment （P d0.05） ; but the difference of blood creatinine, urea nitrogen were not significant between the two groups after treatment （P〉0.05）. Postoperative urine volume and renal function recovery time of the observation group were （6.38± 2.32） and （6.14 ± 2.41） d, the corresponding data of the control group were （6.53 ± 2.74） d and （6.23 ±2.59） d, showing significant difference between the two groups （P〉0.05）. Con- clusion： Transurethral Holmium laser lithotripsy and double positioning extracorporeal shock wave litho- tripsy show equal good effects for acute renal failure caused by upper urinary tract calculi.