上尿路结石致重度肾积水24例临床研究

Clinical treatment of 24 cases of severe renal hydronephrosis caused by upper urinary tract calculi

目的分析研究上尿路结石致重度肾积水的临床治疗方法及最大可能保肾的可行性。方法对24例上尿路结石并重度肾积水患者,先行患侧经皮肾穿刺造瘘解除梗阻,再根据情况择期行微创经皮肾镜取石术、输尿管镜气压弹道碎石术或开放手术取石及肾切除手术。结果除肾切除患者外,积水肾功能均获不同程度改善,全部患者症状缓解,痊愈出院。结论对于上尿路结石致重度肾积水患者,应先行积水肾经皮肾穿刺造瘘,再根据结石大小、部位、梗阻程度及肾功能情况,择期微创经皮肾镜取石术、输尿管镜气压弹道碎石术或开放手术取石,可取得较好的临床效果且安全性好。

Objective To investigate the experiences in treatment upper urinary stones and severe hydronephrosis. Methods 24 patiences who had upper urinary stones and severe hydronephrosis firstly were treated with percutaneous puncture stoma to relief hydrortephrosis,and then treated with MPCNL, URL, nephrolithotomy or nephrectomy according to the stone size, location and the function of kidney. Results Besides the patients of nephrectomy,all patients were improved in hydronephrosis.24 cases were relieved symptoms and recovery to leave hospital . Conclusion According to the stone size and location and the function of kidney,firstly using percutaneous puncture stoma, and secondly using MPCNL, URL or nephrolithotomy is an excellent modality which is safe and effective.