急诊输尿管镜在结石致急性上尿路梗阻的临床应用

目的探讨急诊输尿管镜治疗结石致急性上尿路梗阻的临床效果。方法回顾分析本院2009年5月～2011年12月因结石致急性上尿路梗阻的41例患者的临床资料。结果所有患者均一次性解除梗阻,一次性碎石取石成功29例。7例结石位于上段,部分碎石后返回肾盂,5例因病情较重未予以碎石;术后常规留置D-J管2～4周,12例残留结石患者术后二期行ESWL。术后患者肌酐（Cr）、尿素氮（BUN）均恢复正常,患者腰痛迅速缓解,感染得到有效控制。结论急诊输尿管镜技术能够尽早解除上尿路梗阻,安全有效,为结石引起的急性上尿路梗阻的有效治疗方法。

Clinical application of emergency ureteroscopy in treatment of acute upper urinary tract obstruction caused by calculi

Objective To study effect of emergency ureteroscopic in treatment of acute upper urinary tract obstruction caused by calculi. Methods Clinical datas of 41 patients with acute upper urinary tract obstruction caused by calculi treated with emergency ureteroscopy in our hospital form May 2009 to September 2011 were analyzed retrospectively. Results All cases removed obstruction by emergency ureteroscopy one-time, 29 cases of ureteral calculus were fragmented successfully. Seven cases of calculus located on the upper segment of ureteral were fragmented partly and push into renal pelvis, 5 cases of the heavy illness were not carried out pneumatic lithotripsy. All cases were conventionally retained D-J tube for 2-4 weeks. The postoperative residual stones of 12 cases cured by ESWL two-stage. Postoperative creatinine (Cr) and urea nitrogen (BUN) levels were back to normal, waist pains were relieved rapidly, and infection was control effectively. Conclusion Emergency ureteroscopy can remove the urinary tract obstruction as early as possible due to its safety and efficiency. It is an effective treatment method for the patients with acute upper urinary tract obstruction caused by calculi.