输尿管镜在急性肾后性梗阻并感染中的应用

Application of ureterscope in acute postrenal obtruction with infection

目的探讨输尿管镜在急性肾后性梗阻中的应用。方法回顾性分析39例急性肾后性梗阻应用输尿管镜治疗的临床资料，25例行急诊手术，14例给对症处理＋抗感染1-3d，临床症状无明显改善，改行手术治疗，均采用输尿管镜下电子弹道碎石＋D-J管置人术。结果39例经输尿管镜手术治疗，一次性解除梗阻38例，所有患者术后寒战、高热症状均缓解，肾功能均有不同程度恢复。结论应用输尿管镜治疗输尿管结石或狭窄引起急性肾后性梗阻所致的肾积脓是一种安全、有效、微创的方法。

Objective To explore the application of ureteroscope in acute postrenal obstruction. Methods The clinical data of 39 patients with acute postrenal obstruction by using ureteroseope therapy were retrospectively analyzed. 25 patients were treated with emergency operation, 14 patients who adopted broad-spectrum antibiotic therapy for 1 to 3 days without significant improvement in clinical symptoms were proceeded with operations, which employed ureteroscope elctronic lithotripter with D-J tube insertion. Results Of the 39 cases, the obstructions of 38 cases were removed away after using ureteroscope only once. Their symptoms,such as chill and hyperthermia relieved and their renal functions were recovered in different level after operation. Conclusion Application of ureteroscope was a safe, effective and minimally invasive treatment for acute pyonephrosis caused by postrenal obstruction from ureterolith or stegnosis.