双肾积水59例诊治体会  

Diagnosis and therapy of bilateral hydronephrosis (reportof 59 cases)

作　　者：王毅东[1] 赵文兵[1] 姚蔚[1] 耿仲平 范常胜[1] 王文忠[1] 

机构地区：[1]太原铁路中心医院泌尿外科,太原030013

出　　处：《山西医科大学学报》2004年第4期369-371,共3页Journal of Shanxi Medical University

摘　　要：目的　提高各种病因所致双肾积水的诊疗水平。方法　对 5 9例B超诊断的双肾积水患者的诊治经过做回顾性分析总结。结果　 5 6例患者经病因治疗或双侧肾盂引流 ,肾功能得到恢复或不同程度改善 ,1例癌症晚期患者未治疗死亡 ;1例无梗阻 ;1例失访。结论　双肾积水为双侧输尿管或下尿路的机械性或功能性梗阻性病变所致 ,治疗方法为解除梗阻、保护肾功能 ,把握手术适应证及双侧治疗的先后时机尤为重要。对于急性肾后性肾功能衰竭或不能耐受原发病手术的患者 ,首选双侧肾盂穿刺或膀胱镜下双侧输尿管置入D -J管引流 ,可避免透析治疗。Objective To improve the level of diagnosis and therapy of bilateral hydronephrosis with varied causes. Methods Fifty-nine patients with bilateralhydronephrosis diagnosed by ultrasonography were reviewed. Results Of them56 patients received causal treatment or bilateral renal pelves puncturing andurine draining, and their renal function recovered or improved. One patient with later-period carcinoma refused treatment and died, one had no obstruction, and one was lost to follow up. Conclusion The cause of bilateral hydronephrosis is mechanical or functional obstruction of bilateral ureters. The treatment is eliminating obstruction and protecting renal function. It is very importantthat knowing well the operation indication and treatment sequence of bilateralnephropathy.For the patients of acute postrenal failure or the patients can nottolerate the support operation, the first choice therapy is bilateral renal pelve puncturing or permanent catheter drainage D-J tube. These methods can avoidhemodialysis.

关 键 词：肾盂积水 尿道梗阻 引流术 肾功能衰竭 

分 类 号：R692.2[医药卫生—泌尿科学]