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目的提高上尿路梗阻并发肾积脓的诊治水平。方法分析35例上尿路梗阻并发肾积脓患者的临床特点、诊断和治疗,并结合文献进行讨论。结果10例行肾切除,17例I期行肾盂或输尿管切开取石、双J管内引流加肾造瘘术,8例经皮肾穿刺造瘘或经膀胱镜双J管内引流,经抗生素治疗病情稳定后行Ⅱ期手术。术后随访肾功能均有不同程度恢复。结论早期诊断,及时引流,解除梗阻是脓肾保肾治疗的关键。B超在脓肾早期诊断中有重要作用,肾积脓引流后二期手术,可明显降低肾切除率。
Objective To improve the diagnosis and treatment of upper urinary tract obstruction complicated with pyelonephritis. Methods The clinical features, diagnosis and treatment of 35 patients with upper urinary tract obstruction complicated with pyorrhea were analyzed and discussed in the literature. Results of 10 cases of nephrectomy, 17 cases of I line renal pelvis or ureterolithotomy, double J tube drainage and nephrostomy, 8 cases of percutaneous nephrostomy or double cystoscopy J drainage, antibiotic treatment of the disease Stable after surgery Ⅱ. Postoperative follow-up renal function has varying degrees of recovery. Conclusion Early diagnosis, timely drainage, relieve obstruction is the key to purulent kidney treatment. B ultrasound in the early diagnosis of pus has an important role in the second stage after drainage of renal pelvis surgery, can significantly reduce the rate of nephrectomy.