急性肾后性肾功能衰竭的外科治疗

Treatment of the Acute Postrenal Renal Failure

目的:探讨急性肾后性肾功能衰竭的治疗方法。方法:对22例急性肾后性肾功能衰竭的患者,根据具体病情不同,分别行输尿管镜下气压弹道碎石术、经皮肾造瘘术、膀胱镜下双“J”管置入术及急诊开放手术治疗。结果:除1例双侧先天性肾盂输尿管交界处狭窄(UPJ)患者因膀胱镜下置入双“J”管效果不佳,并拒绝进一步治疗自动出院外,其余21例患者均治愈出院,肾功能于手术后5～25d均恢复正常。结论:对急性肾后性肾功能衰竭应针对不同病因采取灵活的治疗方法;微创治疗具有创伤小、安全可靠、患者术后恢复快等优点,在治疗急性肾后性肾功能衰竭中有着重要作用。

Objective： To investigate various methods for treating acute postrenal renal failure （APRF）. Methods：According to specific patient＇s conditions, 22 cases with APRF respectively received air pneumatic pressure lithoclasty under ureteroscope, invasive percutaneous nephrostomy, retrocatheteris of double J tube with help of cystoscope and emergency open operation. Results： 21 of 22 cases were cured after operation, their renal function got normal within 5 to 25 days. Another case with congenital hibateral ureteropelvic junction stenosis did no t get well with the retrocatheteris of double J tube under cystoscope. He refused to adopt further treatment and insisted to be out of hospital. Conclusions：Various treatment methods for APRF should be adopted according to specific patient＇s conditions. Minimal treatment method has adventages of minimal invasion, safety, quick recovery, and plays an important role in the treatment of APRF.