复杂性肾结石并慢性肾功能不全47例的治疗  

Treatment of 47 patients with complex renal calculus with chronic renal insufficiency

作　　者：张书贤[1] 喻彬[1] 郭松林[1] 王玉清[1] 程炳南[1] 殷传开[1] 

机构地区：[1]皖南医学院第二附属医院泌尿外科,安徽芜湖241000

出　　处：《现代泌尿外科杂志》2003年第4期229-230,共2页Journal of Modern Urology

摘　　要：目的 提高复杂性肾结石并慢性肾功能不全的治疗水平。方法 收集47例复杂性肾结石并慢性肾功能不全的病例,比较几种不同的方法对肾功能恢复的影响,其中不阻断血流取石18例(A组),原位低温阻断肾血流取石22例(B组),保守治疗7例(C组)。结果 治疗后3月血Cr下降人数比:A组100％,B组81.8％,其中4例术后出现肾功能衰竭,C组28.6％。治疗后6月血Cr平均下降值: A组232.3μmol·L-1, B组87.2μmol·L-1, C组10.6μmol·L-1。结论 不阻断肾血流的取石肾脏损害轻,预后较为理想。阻断肾血流取石,多数病例预后较好,但少数加重肾脏的损害,导致术后肾功能衰竭,应警惕。消极等待不如积极治疗。AIM To Study the diagonsis and treatment of complex renal calculus with chronic renal insufficiency.METHODS 47 cases of complex renal calculus with chronic renal insufficiency were collected.The effectiveness of different treatments on renal function's recovery were compared : stone was removed without interruption of renal blood flow in 18 (A group), with interruption of renal blood flow under hypothermia original site in 22 (B group) , and conservative treatment in 7(C group). RESULTS Proportion of cases with blood Cr reducing;group A100%; group B 81.8%, with renal failure in 4 cases ; group C 28.6%. Range of blood Cr reducing 6 months later: group A 232.3μmol-L-1, group B 87.2μmol-L-1, group C 10.6 μmol-L-1. CONCLUSION Without interruption of renal blood flow is less harmful and the prognosis is excellent.Most cases with interruption of renal blood flow is good, but some of them presented with renal failure because of the more influence suffered , that should be noticed.Conservative treatment has low risk, the remaining renal function may be lasted a long period, but active therapy is better than inactive.

关 键 词：复杂性肾结石 并发症 慢性肾功能不全 治疗 肾功能衰竭 

分 类 号：R692.4[医药卫生—泌尿科学] R692.5[医药卫生—外科学]