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目的总结急诊处理上尿路结石肾功能衰竭的经验与教训。方法回顾分析2000年1月～2006年10月收治的86例上尿路结石肾功能衰竭患者的急诊处理方法,其中急诊开放手术28例,输尿管行插管引流12例,经皮肾穿刺造口20例,输尿管镜(URS)气压弹道碎石或置双J管26例。结果开放手术患者中,术后死亡1例,肾功能未能恢复5例;经输尿管逆行插管、经皮肾穿刺造口和输尿管镜处理的58例,行尿液引流后,BUN、Cr都有不同程度的降低或恢复正常,为后期的病因治疗增加了手术的安全性。结论对此类患者要先判断是急性肾功能衰竭还是慢性肾功能衰竭基础上并发急性肾功能衰竭,然后采取不同的急诊处理方法。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。
Objective To summarize the experiences and lessons of emergency treatment of upper urinary tract calculi and renal failure. Methods A retrospective analysis of 86 cases of upper urinary tract calculi in patients with renal failure from January 2000 to October 2006 emergency treatment, including emergency open surgery in 28 cases, ureteral catheter drainage in 12 cases, percutaneous nephrostomy 20 cases, ureteroscopy (URS) pneumatic lithotripsy or double J tube 26 cases. Results In open surgery patients, 1 case died of postoperative death and 5 cases failed to recover renal function. After ureter retrograde intubation, percutaneous nephrostomy and ureteroscopic treatment of 58 cases, after urinary drainage, BUN and Cr Have different degrees of reduction or return to normal, for the latter etiological treatment increased surgical safety. Conclusions For these patients, the first diagnosis of acute renal failure or chronic renal failure complicated with acute renal failure, and then take a different emergency treatment. First to be diverted urine is an emergency treatment of upper urinary tract stones in patients with renal failure effective and safe method.