老年患者上尿路结石梗阻伴肾功能衰竭的治疗

Treatment of aged cases with upper urinary tract stone obstruction accompanied by renal failure

目的探讨适合老年患者的上尿路结石梗阻伴肾功能衰竭的处理方法和疗效。方法通过B超、KU B、CT膀胱镜逆行插管检查明确诊断,通过ESW L一侧或双侧输尿管切开取石,肾盂切开取石,输尿管内置双J管或肾造瘘等方法治疗解除梗阻。结果本组11例患者治疗后肾功能不全症状减轻或消失。其中治愈2例,肾功能改善9例,但未能恢复正常。结论应根据老年患者的身体状况,选择创伤较小的有效治疗方法,及时治疗上尿路结石梗阻合并的肾功能衰竭、挽救肾功能。

Objective To investigate curative effect and suitable way dealing with aged cases of upper urinary tract stone obstruction leading to renal failure. Methods The diagnosis was obtained by using ultrasound,KUB,CT and cystoscopy retrograde urography. Obstruction was relieved by treatment with ESWL,one or bilateral ureterolitho- tomy,pyelolithotomy,ureterocatheterization or pyelostomy. Results Uraemic symptom of 11 cases was alleviated or eradicated. 2 cases were cured. Renal function of 9 cases was improved but abnormal. Conclusioh In accordance with body condition of aged patients,small wound effective treatment should be selected. Upper urinary tract stone obstruction leading to renal failure shouled be treated early so as to save the renal function.