上尿路梗阻性少尿的诊治

The Treatment of Oligouria Due to Upper Urinary Obstruction.

目的:探讨上尿路梗阻性少尿患者的处理。方法:分析58例上尿路梗阻性因素所致的少尿患者的临床资料。结果:26例结石患者综合使用膀胱镜逆行插管、输尿管镜碎石、体外震波碎石和开放手术均平稳取石;32例肿瘤患者中26例作尿流改道,逆行插管和B-US引导下穿刺的使用使得开放手术的必要性和危险性大为减少,但前者的近期失败几率较大(11/35),而且引流前后患者的病理生理状况改变极大。结论:要根据不同病因,选择合适的治疗方案,围手术期的病情观察与处理十分重要。

Purpose:To investigate the treatment of oligouria due to upper urinary obstruction. Methods: The clinical materials of 58 patients suffering from upper urinary tract obstructive oligouria were analysed retro-spectively. Results: According to the combination of endoscopic retrograde ureteral catheterization, urteroreno-scopic lithotripsy,ESWL and ureterolithotomy, All of the 26 patients were stone-free successfully. While 26 of the 32 cases with advanced malignant tumors received urinary diversion, the necessity and risk of open operation decreased markedly due to the use of retrogradeureteral catheterization and the percutaneous nephrostomy under ultrasound guidance. But both of the two technigues had high failure risk and the change of pathophysiology was remarkable after urinary diversion. Conclusion: Appropriate regime should be choosed according to the different causes, and the perioperative critical care was very important.