摘要
目的 :总结急诊处理由结石引起的梗阻性肾功能衰竭的经验与教训。方法 :对 1988年 1月～ 2 0 0 0年 5月收治的 81例梗阻性肾功能衰竭患者的急诊处理方法进行回顾性分析 ,其中行急诊开放手术 14例 ,输尿管逆行插管引流 36例 ,经皮肾穿刺造口 31例 ;引流失败的 8例 ,1例改行 URS,7例改行经皮肾穿刺造口。结果 :死亡 3例 ,1例为开放手术者 ,2例为穿刺造口者 ;引流成功 2 8例 ,无一例出现严重并发症 ;穿刺造口者有 3例行肾切除术 ,手术后病情改善 ,血清肌酐下降。结论 :对此类患者应特别注意出血倾向对外科手术的严重影响 ,在患者出血倾向未得到纠正以前切勿轻易进行复杂的外科处理。
Purpose:To present the experiences and lessons of emergency management for the obstructive renal failure induced by urinary calculi.Methods:Clinical data of 81 cases of patients with obstructive renal failure from January 1988 to May 2000 was reviewed retrospectively.Results:14 cases were treated by emergent open operation (one died of bleeding ceaselessly), 36 cases by dwelling ureteral stent retrogradely(28 cases succeeded and no severe complications observed, the other 8 cases received nephrostomy of TUL),38 cases treated with percutaneous nephrostomy drainage(3 cases had to undergo nephrectomy, and the other 2 patients died after the primary treatment because of bleeding continually). The serum creatinine level decreased significantly after treatments(P< 0.01 ).Conclusions:It is noteworthy that the surgical interventions were affected severely by the bleeding tendency caused by uremia, and the complicated surgical intervention could not be carried out before the bleeding tendency be corrected. The indwelling ureteral stent retrogradely is recommended as the first choice of emergent treatment for patients with obstructive renal failure.
出处
《临床泌尿外科杂志》
2001年第2期70-71,共2页
Journal of Clinical Urology
关键词
梗阻性肾功能衰竭
急诊
处理
Renal failure
Obstructive
Emergency treatment
