双侧上尿路结石并发肾功能不全术后急性肾衰的处理

目的：探讨治疗双侧上尿路结石并发肾功能不全术后急性肾衰的方法。方法：对54例双侧上尿路结石并发肾功能不全术后急性肾功能衰竭（ARF）患者的治疗方法进行回顾性分析，根据不同病情分别行急诊输尿管镜碎石（URL）和输尿管逆行插管或经皮肾造瘘（PCN）后二期碎石。所有病例监测血肌酐（Cr）和尿素氮（BUN）。结果：术后全部患者血Cr和BUN进行性下降，恢复到正常43例，氮质血症6例，尿毒症4例，死亡1例。结论：双侧上尿路结石并发肾功能不全应早期诊断，选择恰当的外科治疗时机和方法，一旦术后出现ARF，要立即明确原因，进行治疗。

Treatment of Postoperative Acute Renal Failure in Bilateral Upper Urinary Calculi with Renal Insufficiency

Objective： To explore the treatment of postoperative acute renal failure in bilateral upper urinary calculi with renal insufficiency. Methods： A retrospective review was made on 54 cases with postoperative acute renal failure （ARF） in bilateral upper urinary calculi with renal insufficiency. According to different disease, patients were performed emergently with ureteroscopic lithotripsy（URL） and retrograde ureteral catheterization or percutaneous nephrostomy（PCN） needed a second lithotripsy later. All cases were monitored serum creatinine （Cr） and blood urea nitrogen （BUN）. Results： After operation, all the blood Cr and BUN in patients declined progressively, 43 cases got normal serum Cr and BUN levels, 6 cases got azotemia, 4 cases got uremia, and 1 case died. Conclusions： Peoples of bilateral upper urinary calculi with renal insufficiency were made early diagnosis, only in a good operation way and proper time can be treated. Acute renal failure after operation should be made correct etiologic diagnosis and treatment in time.