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)

[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。

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

[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.