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目的:探讨超声引导经皮穿刺顺行输尿管支架管置入术治疗恶性肿瘤引起的输尿管狭窄导致的肾功能衰竭的应用价值及安全性。方法:对11例患者经超声引导下行双侧肾盂穿刺,透视下双侧顺行放置输尿管支架管,术后观察肾功能恢复情况。结果:11例共22只输尿管支架管置放术均一次成功,无严重并发症出现。术后1周血肌酐、尿素氮恢复正常。术后经肾脏超声、CT随访检查,肾盂、输尿管扩张积水均消失,患者腰痛症状消失。术后生存时间4～12个月,平均5个月,患者最终因肿瘤进展而死亡。结论:超声引导经皮穿刺顺行输尿管支架管置入术,治疗原发或转移性恶性肿瘤引起的输尿管狭窄导致的肾功能衰竭安全可靠、并发症少,可有效延长患者的生存期,改善生存质量。
Objective: To investigate the value and safety of ultrasound-guided percutaneous puncture of ureteral stent for the treatment of renal failure caused by ureteral stricture caused by malignant tumor. Methods: Eleven patients underwent ultrasound-guided bilateral pelvis puncture. Ureteral stents were placed on both sides of the ureter directly under fluoroscopy. The recovery of renal function was observed after operation. Results: A total of 22 ureteral stents were placed successfully in 11 cases without serious complications. After 1 week serum creatinine, urea nitrogen returned to normal. Postoperative renal ultrasound, CT follow-up examination, renal pelvis, ureteral dilatation of water were disappeared, the symptoms disappeared. Survival time 4 to 12 months, an average of 5 months, the patient eventually died of tumor progression. Conclusion: Ultrasound-guided percutaneous puncture along the ureteral stent implantation, the treatment of primary or metastatic malignant tumors caused by ureteral stricture of renal failure is safe and reliable, with fewer complications, which can effectively prolong the survival of patients and improve survival quality.