上尿路结石梗阻性急性肾功能衰竭的急诊处置

目的探讨上尿路结石梗阻性急性肾功能衰竭的急诊处理方法。方法回顾分析2003年1月~2008年10月收治的48例上尿路结石肾功能衰竭患者的急诊处理方法,其中输尿管逆行插管引流18例,经皮肾穿刺造瘘10例,输尿管镜气压弹道碎石并留置双J管20例。结果48例患者均成功解除尿路梗阻,无一例死亡。40例术后1个月肾功能恢复正常;8例仍有氮质血症,但肾功能明显改善。结论先予以引流尿液是急诊处理上尿路结石肾功能衰竭患者的有效安全方法,情况许可则首选输尿管镜气压弹道碎石。

THE EMERGENCY TREATMENT OF OBSTRUCTIVE ACUTE RENAL DYSFUNCTION CAUSED BY UPPER URINARY STONE

Objective To explore the emergency treatment for acute obstructive renal dysfunction caused by upper urinary stones. Methods Clinical data of 48 cases of patients with obstructive renal failure from January 2003 to October 2008 was reviewed retrospectively. 18 eases by dwelhng ureteral steut retrogradel, 10 cases treated with percutaneous nephrostomy, the other 20 cases treated with ureterescopic pneumatic lithotrips and a double “J” tube. Resuits All of the patients were treated successfully, no death. Renal functions recovered to normal within 1 month after operation in 40 cases; different degrees of azotemia remained within 1 month after operation in 8 cases, but their renal functions were improved significantly. Conclusion Draining the urine is safety and efficiency to treate acute obstructive renal dysfunction caused by upper urinary stones, ureterescopic pneumatic lithotrips can be recommended as the first choice if the conditions allowed.