气压弹道碎石治疗上尿路结石致急性肾衰竭

目的:探讨上尿路结石引起急性梗阻性肾功能衰竭的治疗方法。方法:对46例上尿路结石梗阻导致急性肾衰竭患者,20例经输尿管镜下气压弹道碎石,20例经皮肾镜气压弹道碎石。6例输尿管镜结合经皮肾镜气压弹道碎石。结果:40例术后(2～10)d BUN、CR下降至正常,6例BUN、CR明显下降仍高于正常,35例一次治愈,6例二次经皮瘘道清石结石清除,5例结合ESWL术治疗结石排除。结论:结石梗阻性肾功能衰竭采用气压弹道治疗能及时解除梗阻,有效地保护肾功能,损伤小并发症少,操作简单、安全、有效。

Effect of Pneumatic lithotripsy in Treatment of Acute Obstructive Renal Disfunction Caused by Upper Urinary Tract Stones

Objective:To explore the method for treating acute obstructive renal disfunction caused by upper urinary stones.Methods:Forty-six patients with acute obstructive renal disfunction caused by upper urinary tract stones were treated by ureteroscopy and pneumatic lithotripsy,minimally invasive percutaneous nephrolithotomy(MPCNL).Results:The BUN and CR of 40 cases decreased to normal,and the other 6 decreased obviously but still higher than nomal during 2-10 days.Thirty-five patients were cured at primary procedure.Five patients lithecboled after extracorporeal shock-wave lithotripsy.The calculus of six patients was evacuated percutem fistulous tract.Conclusion:Pneumatic lithotripsy could eliminate obstruction in time and preserve renal function efficiently with minimal injury and complications in patients with obstructive renal disfunction caused by upper urinary stones.This method is simple,safe and efficient.