论文部分内容阅读
目的:研究输尿管镜钬激光配合输尿管管路封堵器治疗双侧输尿管结石并急性梗阻性肾功能不全的疗效和安全性。方法:回顾29例双侧输尿管结石并急性梗阻性肾功能不全患者资料,均采用输尿管管路封堵器固定结石输尿管镜钬激光碎石解除梗阻,术中留置双J管,并比较手术前、手术后血肌酐(SCr)、血尿素氮(BUN)、24小时尿量的变化情况。结果:29例一次性手术成功,手术时间35~70min;SCr、BUN于术后2天开始下降,25例术后1周SCr、BUN正常,4例SCr维持在286~437μmol/L,BUN 13.0~19.3mmol/L,术后4周影像学随访,29例无明显结石残留。术后随访3~9个月,结石无复发,28例肾功能正常,1例SCr维持在268~275μmol/L之间,BUN 13.0~14.1mmol/L之间。结论:输尿管镜钬激光配合输尿管管路封堵器治疗双侧输尿管结石并急性梗阻性肾功能不全安全、迅速、疗效显著,患者恢复速度快,可作为此类疾病重要的治疗方法之一。
Objective: To study the efficacy and safety of ureteroscopic holmium laser combined with ureteral occluder in the treatment of bilateral ureteral calculi and acute obstructive renal insufficiency. Methods: The data of 29 patients with bilateral ureteral calculi and acute obstructive renal insufficiency were retrospectively analyzed. Ureteral occluder and ureteroscopic holmium laser lithotripsy were used to relieve obstruction. Intraoperative double J tube was used. Postoperative serum creatinine (SCr), blood urea nitrogen (BUN), 24-hour urine output changes. RESULTS: Twenty-nine patients underwent one-time surgery and the operative time was 35-70 minutes. SCr and BUN decreased at 2 days after operation. SCr and BUN were normal in 25 cases at 1 week after operation. SCr was maintained at 286-437 μmol / L in 4 cases and BUN 13.0 ~ 19.3mmol / L, 4 weeks postoperative imaging follow-up, 29 cases no obvious residual stones. The patients were followed up for 3 to 9 months without recurrence of stones and normal renal function in 28 cases. The SCr was maintained between 268 and 275 μmol / L in one case and between 13.0 and 14.1 mmol / L in BUN. Conclusions: Ureteroscopic holmium laser combined with ureteral occluder is a safe and rapid method for the treatment of bilateral ureteral calculi and acute obstructive renal insufficiency, and the curative effect is obvious. The recovery speed of the patients can be regarded as one of the important treatment methods for such diseases.