保肾手术治疗结石性脓肾的价值

目的：探讨结石性肾积脓(结石性脓肾)的病理特点及保肾手术治疗的价值。方法：对31例一期取石加肾造瘘或输尿管放置双J管的结石性脓肾患者的临床资料进行分析。男19例，女12例；平均年龄38岁。左侧11例，右侧20例。发病时间平均3年5个月。结果：术后随访23例，患肾功能恢复或部分恢复18例(78．3％)，术后1年发生肾萎缩5例(21．7％)，复发结石3例(13.0％)。结论：发病时间较短、梗阻解除后肾皮质血运改善的结石性脓肾保肾手术是可行的，局部肾皮质厚薄并非保留患肾的主要依据。

Kidney sparing operation in the surgical treatment of calculous pyonephrosis

Objective To investigate the feasibility of kidney sparing operation in the surgical treatment of calculous pyonephrosis. Methods 31 cases of calculous pyonephrosis were treated by nephrolithotomy or ureterolithotomynephropyelostomy with a double J catheter stent in the ureter.23 cases have been followed up and evaluate. Results The renal function returned to some extent in 78.3%(18/23).However,renal atrophy was observed in 21.7%(5/23) one year after and stone recurrence in 13%(3/23). Conclusions Calculous pyonephrosis of short course on reliving the obstruction would cause the return of renal blood circulation and renal function in near 80.0% of the cases.Thickness of the remaining renal cortex might not be the sole parameter to keep the kidney or not.To save the kidney in calculous pyonephrosis of short course might be feasible.