急性上尿路梗阻性无尿应注意的临床问题

目的 提高对急性上尿路梗阻性无尿的认识,妥善处理相应的临床问题。方法 对55例急性上尿路梗阻性无尿患者的临床问题进行总结、分析。无尿、腰痛、水肿及血肌酐、尿素氮进行性增高是主要诊断依据;B超和腹部平片(KUB)是首选检查方法;治疗原则是尽快解除梗阻,有效防治感染,最大限度地保护肾功能。结果 肾功能恢复正常者43例(78．2％);治疗后3个月仍有氮质血症者10例(18．2％);患者放弃治疗者2例。结论 重视无尿症的肿瘤病因。治疗首选经膀胱镜输尿管插管,慎用利尿剂。

Attentive problem in the clinic about acute obstructive anuria at upper urinary tract

Objective To improve the understanding of acute obstructive anuria at upper urinary tract in order to cope properly with corresponding clinical problems. Methods The clinical problems of acute obstructive anuria at upper urinary tract in 55 patients was summarized and analysed. Anuria,lumbago,edema and progressive increase of blood creatinine and ureal nitrogen were the main bases of diagnosis.B-typed ultrasonography and plain film of abdomen(KUB) were the first choice in examinations. The treatment principles lied in prompt removal of obstruction as well as effective prevention and treatment of infection to protect renal function to maximum extent. Results Forty-three cases (78.2%) recovered normal renal function. Ten cases (18.2%) still had azotemia three months after treatment. Two cases gave up treatment. Conclusions The reason of tumor for anuria should be paid attention to. The first choice in treatments is ureteral intubation by cystoscope. Diuretic should be used cautiously.