输尿管镜在早期结核性肾积水治疗中的应用  

Application of ureteroscopy in the treatment of tuberculous hydronephrosis

作　　者：阿不都合力里·艾力吾西尔 艾尼瓦尔·艾力 艾克拜尔·吾曼尔[2] 麦伍拉尼·马木提 李建[1] 热木提拉·阿曼 胡安泰·穆沙 马迪[1] Abudouhelili Ailiwuxier;Ainiwaer Aili;Aikebaier Wumaner;Maiwulani Mamuti;LI Jian;Remutila Aman;Huantai Musha;MA Di(Department of General Surgery,The Eighth Affiliated Hospital of Xinjiang Medical University,Urumqi,830001,China;The Urology Center of People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,830001,China;The Department of Urology,the Seventh Affiliated Hospital of Xinjiang Medical University,Urumqi,830001,China)

机构地区：[1]新疆医科大学第八附属医院普外科,乌鲁木齐830001 [2]新疆维吾尔自治区人民医院泌尿中心,乌鲁木齐830001 [3]新疆医科大学第七附属医院泌尿外科,乌鲁木齐830001

出　　处：《新疆医学》2024年第1期54-56,93,共4页Xinjiang Medical Journal

摘　　要：目的探讨输尿管镜在早期结核性肾积水治疗中的应用。方法选取新疆医科大学第八附属医院2018年12月-2020年12月收治的43例结核性肾积水患者的临床资料。术前行抗结核治疗2周后行经尿道输尿管镜探查+输尿管狭窄扩张+输尿管支架置入术,术后继续抗结核治疗12个月。对治疗前后相关指标(血沉、尿常规、GFR、积水程度)进行分析。结果患者完成术后随访12月。术后患肾GRF水平有所增高,肾积水明显改善;尿常规中尿WBC、尿RBC明显减少、血沉下降,与术前比较术后3月、6月、9月、12月水平差异有统计学意义(P<0.05);尿PRO术后3个月开始减少,术后9月转阴率达到100%(P<0.05)。结论对结核性肾积水患者术前抗结核治疗2周后行经尿道输尿管镜探查+扩张+支架置入术后感染指标下降,患肾功能改善,是一种有效治疗方法之一。Objective To discuss the application of ureteroscopy in the treatment of tuberculous hydronephrosis.Methods The clinical data of 43 cases with tuberculous hydronephrosis admitted to the department of general surgery of the eighth affiliated hospital of Xinjiang medical university from December 2018 to December 2020 were collected.Transurethral uretescopic exploration combined with ureteral stricture expansion and ureteral stent placement were performed after preoperative antituberculous treatment for two weeks.After operation,antituberculous treatment was continued for 12 months.The clinical data and relevant indicators including blood sedimentation,urine routine,GFR and degree of nephrosis within 1 year before and after treatment were analyzed.Results The patients were followed up for 12 months.After operation,the GRF level of the affected kidney was increased,and the hydronephrosis was obviously improved.Urinary WBC,RBC and erythrocyte sedimentation rate decreased significantly in routine urine,and the levels of postoperative 3 months,6 months,9 months and 12 months were statistically significant compared with those before surgery(P<0.05);Urine PRO began to decrease 3 months after the operation,and the negative conversion rate reached 100%in 9 months after the operation(P<0.05).Conclusion It is one of the effective treatment methods for the patients with tuberculous hydronephrosis who underwent transurethral ureteroscopy,expansion and stent implantation 2 weeks after the preoperative anti-tuberculosis treatment.

关 键 词：肾结核 肾积水 抗结核 输尿管镜 

分 类 号：R691.2[医药卫生—泌尿科学]