输尿管镜治疗急性梗阻性肾功能衰竭的疗效观察  

The Applications of Ureteroscopy in the Emergency Treatment of Acute Obstructive Renal Failure

作　　者：周伟梁[1] 秦伟毅[1] 肖远松[1] 卢勇[1] 钱洪津[1] 

机构地区：[1]广州军区广州总医院急危重病救治中心,广东广州510010

出　　处：《河北医学》2012年第8期1093-1094,共2页Hebei Medicine

摘　　要：目的:探讨输尿管镜技术在治疗急性梗阻性肾功能衰竭中的应用。方法:对36例尿路梗阻导致急性肾功能衰竭患者,11例因严重急性肾衰予以中心静脉导管行经皮肾穿刺造瘘术后血液透析治疗1-2次,其余根据具体病情行输尿管镜下探查、气压弹道碎石取石、置管等微创治疗。结果:30例术后2-9dBUN、Cr降至正常;2例术后10-15dCr仍在196-262mmoL/L,1个月后正常,4例因一侧肾切除或一侧先天独肾等对侧肾功能差,3个月复查仍处于氮质血症期。无输尿管穿孔和黏膜撕脱的并发症发生。结论:应用输尿管镜技术治疗急性梗阻性肾功能衰竭是一种安全、有效、微创的方法,能同时处理双侧输尿管梗阻病变。Objective： To summarize the clinical applications of ureteroscopy in the treatment of acute obstructive renal failure. Method：36 cases of acute obstructive renal failure due to urinary obstruction were included, 11 cases were given hemodialysis by once to twice after percutaneous nephrolithotomy through cen-tral venous catheter, followed by diverse treatment such as ureteroscopic exploration, ballistic lithotripsy and catheter indwelling based on their own conditions. Result： After the operations, the serum BUN （ blood ure-a nitrogen） and Cr （ creatinine）levels of 30 patients were decreased to normal in 2-9 days; only 2 cases had persistent high levels of Cr at 196-262mmoL/L in 10-15 days. In 4 cases of previous unilateral ne-phrectomy or congenital solitary kidney, azotaemia remained after 3 months, no ureter perforation or avulsion occurred. Conclusion：Ureteroscopy is a minimal invasive, safe and effective treatment in acute renal failure due to urinary obstruction. It is applicable to bilateral ureteral obstruction.

关 键 词：输尿管镜 急性梗阻性肾功能衰竭 中心静脉导管 经皮肾穿刺造瘘术 

分 类 号：R692.5[医药卫生—泌尿科学]