急性上尿路梗阻所致自发性尿外渗的临床诊疗(附13例临床报告)  

Clinical diagnosis and treatment of spontaneous urinary extravasation caused by acute upper urinary tract obstruction

作　　者：李彬彬[1] 张劲勍[1] 朱泳新[1] 洪景范[1] 杨增士[1] 叶宁[1] 卓红兵[1] 李刚[1] 沈勇虎[1] 

机构地区：[1]南方医科大学附属小榄医院泌尿外科,广东中山528415

出　　处：《中国伤残医学》2013年第8期27-29,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨急性上尿路梗阻所致自发性尿外渗的临床表现,发病机制、诊断和治疗方法。方法:回顾性分析13例上尿路急性梗阻导致尿外渗的病例特点、诊断和治疗过程。7例行经尿道输尿管镜下取石或碎石后留置双J管。2例置管失败后行超声引导下肾穿刺造瘘术引流。1例行经皮肾穿刺碎石术。2例开放手术恢复上尿路通畅性。结果:13例患者均及时确诊,梗阻解除后,均恢复良好,无并发症发生。结论:上尿路急性梗阻导致尿外渗以输尿管和肾结石多见,影像学检查特别是CTU检查是确诊本病的主要手段。治疗原则应积极解除上尿路梗阻,充分引流外渗尿液,控制感染及并发症。Objective：To investigate the clinical performance, pathogenesis, diagnosis and treatment of acute upper urinary tract obstruction due to spontaneous urinary extravasation. Methods： A retrospective analysis of the course of diagnosis and treatment of 13 cases of upper urinary tract acute obstruction leading to urinary extravasation was performed. 7 cases adopted transurethral ureteroscopic lithotripsyand had double J tubes planted. 2 cases adopting the the renal puncture fistulization drainage guided by the uhrasound after failing to put the tube. 1 underwent percutaneous lithotripsy. 2 cases adopting open surgery to recovery the patency of upper urinary tract. Results：13 patients acquired good recovery with no complications after elimination of the obstruction. Conclusion：The ureter and kidney stones were tend to induce urinary extravasation caused by acute upper urinary tract obstruction. The imaging examinations, especially the CTU, were the primary means of diagnosis of the disease. Principles of treatment should include actively releasing of upper urinary tract obstruction, drainaging extravasation adequately and controlling the infection and complications.

关 键 词：上尿路梗阻 自发性尿外渗 

分 类 号：R694[医药卫生—泌尿科学]