经尿道输尿管镜治疗梗阻性脓肾17例病例分析

目的探讨经尿道输尿管镜治疗梗阻性脓肾的临床应用。方法从2008年6月～2010年8月收治上尿路结石梗阻性脓肾患者17例,经尿道输尿管镜下气压弹道碎石取石术。结果 16例输尿管中上段结石患者1次碎石、取石成功。1例输尿管上段结石患者术中碎石过程中碎石块冲回肾内,2周后经体外冲击波碎石后结石排出。17例患者手术时间28～120min,平均46min。17例患者术后1～3d体温降至正常,腰痛症状消失。术后4～8周拔出双J管。随访3～12个月,IVP提示患肾积水均有减轻。结论结石梗阻性脓肾的患者应用输尿管镜技术具有同时处理输尿管结石,解除梗阻,充分引流脓液,以及使用敏感抗生素,提高保肾率。具有疗效好、损伤小、安全可靠、恢复快等优点,值得临床推广应用。

Analysis the Transurethral urethroscopy in treatment of 17 cases with obstructive pyonephrosis

OBJECTIVE To explore the clinical application of urethra urethroscopy in treatment of sepsis obstruction sex kidney.METHODS 7 cases with urinary obstruction sex were slected from our hospital from June 2008-August 2010,and urinary ureteroscopic ballistic gravel under the pressure was used to take the stone.RESULTS Among 16 cases with ureteral above the middle upper calculus,one patients successfully performed rubble and took the stone.1 cases dashed back the stone into the kidney,and two weeks later the gravel stones were discharged by the extracorporeal shock wave.The operation time was ranged from 28-120 min for 17 cases,and the average time was 46 min.The temperature of 17 patients drops to normal during 1-3 day,and waist pain symptoms disappeared.The double-J tube was pull out within 4-8 weeks,and the average time was 3-12 months,which suggested the hydronephrosis IVP are reduced.CONCLUSION Urethra urethroscopy in treatment of patients with sepsis obstruction sex kidney ureter stone could remove obstruction,adequate drainage of pus,and use sensitive antibiotics,and improve the kidney rate,which has the aspects of good curative effect,little injury,safe and reliable,rapid recovery.This method is worthy of clinical application.