肾后性肾功能衰竭临床疗效分析

Analysis of clinical effect of post-renal renal failure

目的探讨肾后性肾功能衰竭的病因及临床诊治方法。方法对该院1986年8月～2005年10月收治的各种原因尿路梗阻导致的肾后性肾功能衰竭70例进行分析。根据病因选择经皮肾穿刺造瘘术、膀胱镜逆行留置输尿管导管或双J管内引流、输尿管镜气压弹道碎石后双J管内引流术及开放手术。结果尿石症52例。前列腺增生伴尿潴留12例,神经原性膀胱1例,泌尿系肿瘤5例。经治疗56例症状消失,血尿素氮、血肌酐正常。8例症状改善但血尿素氮、血肌酐未正常。5例症状及血尿素氮、血肌酐无改善。1例死于晚期恶性肿瘤。结论尿路梗阻导致肾后性肾功能衰竭的治疗应根据不同病因,尽早解除梗阻,选择相应治疗方法,恢复尿流畅通,最大限度地挽救和恢复肾功能。

[Objective] To detect the cause and clinical methods to post-renal renal failure （PRRF）. [Methods] 70 cases with PRRF of various causes were analyzed from Aug. 1986 to Oct. 2005. According to the causes, different clinical methods were used such as pereutaneous nephrostomy, drainage with nephric duct catheter or bi-J catheter placed with cistoscope, drainage with bi-J catheter after treatment of ureteroscopy and ballistic lithotripsy, and surgical operation. [Results] Among 52 cases with urinary calculus, 12 cases were with hyperplasia of prostate gland and obstruction of urinary tract, 1 case was with neurogenic bladder, 5 cases were with urologic tumor, 8 patients had ameliorated symptoms but with abnormal BUN and creatinine, 5 patients had unchanged symptoms, abnormal BUN and creatinine, and 1 patient died of malignant tumor of advanced stage. [Conclusion] According to the causes, treatment of PRRF should remove the obstruction early, recover the circulation of urinary tract and re- frain the renal function from damage.