输尿管镜钬激光碎石术治疗急性肾后性肾功能衰竭21例

The emergency treatment of ureteral stone using ureteroscopic holmium:YAG laser lithotripsy for 21 cases of post-renal acute renal failure

目的探讨输尿管镜钬激光碎石术治疗急性肾后性肾功能衰竭的安全性和效果。方法回顾性分析21例因输尿管结石所致急性肾后性肾功能衰竭患者的临床资料,探讨急诊采用输尿管镜钬激光碎石并置管引流的治疗效果。结果21例患者均急诊成功解除尿路梗阻。手术时间为35～110min,平均68.5min,住院时间9～32d,平均16.5d。无输尿管穿孔、断裂或粘膜撕脱等并发症发生,无中转开放手术。随访1～3个月,所有患者血肌酐均恢复正常,复查超声或KUB+IVP,无结石残留。结论输尿管镜钬激光碎石治疗因输尿管结石致肾后性急性肾功能衰竭安全有效,并发症发生率低。一旦明确由于输尿管结石引起的急性肾后性肾功能衰竭,我们推荐首选输尿管镜钬激光碎石及置管引流术,

Objective To summarize the effect and safe of emergency treatment of ureteral stone using ureteroscopic holmium：YAG laser lithotripsy for 21 cases of post-renal acute renal failure （PRF）. Methoda Clinical data of 21 cases of patients with PRF were retrospectively analyzed. All the 21 patients were treated with the ureteroscopic holmium：YAG laser lithotripsy. Resutlts All of the patients were treated successfully, no complications such as urinary fistula, perforation of ureter and renal hemorrhage were obsened. Conclusions Upper urinary tract obstruction is the major cause of PRF and ureteroscope is an important emergency treatment for PRF.The ureteroscopic holmium：YAG laser lithotripsy may be the first choice for the post-renal acute renal failure associated with upper urinary tract stones, due to its safety and efficiency.