输尿管镜碎石治疗输尿管结石合并脓肾的体会

目的：探讨采用输尿管镜碎石治疗输尿管结石合并脓肾的体会。方法：选择2009年5月-2011年10月在笔者所在科室接受诊治的18例输尿管结石合并脓肾患者,均采用输尿管镜下碎石取石术,并置管内引流。结果：采用微创内引流术中均未出现败血症、感染性休克症状。12例随访3个月～2年,所有患肾功能均有不同程度的恢复,无因患肾无功能而采取切肾者。结论：早期诊断、及时引流、解除梗阻是输尿管结石合并脓肾治疗的关键。输尿管镜碎石并留置双J导管是较好的解除梗阻的方法,其安全、并发症较少,可为Ⅱ期手术治疗创造良好的条件。

Treatment of Pyonephrosis Due to Ureteral Calculi with Ureteroscopic Lithotripsy

Objective ： To improve the treatment of pyonephrosis due to ureteral calculi with ureteroscopic lithotripsy. Methods ： 18 patients with pyonephrosis due to ureteral calculi were treated with ureteroscopic lithotripsy followed by tube internal drainage during May 2009 to October 2011. Results ： No complications as septicemia and septic shock occurred during the external drainage. Following up from 3 months to 2 years showed that all of the 12 cases renal function recovered to different degree, and there were no nephrectomy. Conclusion ： The key to the treatment of pyonephrosis due to ureteral calculi operation is early diagnosis, timely drainage and relief of obstruction. Ureteroscopic lithotripsy and double-J placement are good choice to relieve obstruction, safe and with little complication, and can create good conditions for the second stage operation.