上尿路梗阻性肾积脓诊断与治疗

Diagnosis and treatment of upper urinary tract obstructive pyonephrosis

目的：提高上尿路梗阻性肾积脓的诊治水平。方法：对38例上尿路梗阻性肾积脓患者均给予B超定位经皮肾穿刺微造瘘(MPCN)引流尿液再配合输尿管镜碎石术(URL)治疗。结果：30例输尿管下段结石一次性碎石、取石成功；8例输尿管中上段结石术中击碎结石后碎石上移至肾盂内，留置双“J”管经抗感染对症治疗2～3周后行ESWL治疗均未发生感染加重、菌血症、休克等并发症。结论：应用MPCN联合URL治疗结石梗阻性肾积脓是一种安全、可靠的方法。

Objective:To improve the diagnosis and treatment level of upper urinary tract obstructive pyonephrosis.Methods:38 patients with upper urinary tract obstructive pyonephrosis were given B ultrasonic positioning percutaneous renal puncture micro colostomy(MPCN) urine drainage combined with ureteroscopic lithotripsy(URL) treatment.Results:30 cases of distal ureteral calculus had disposable rubble,and calculus removed success.8 cases of upper and middle ureteral calculus had rubble moving up to the pelvis after lithotripsy.They were given indwelling double “J” tube and ESWL treatment after 2 to 3 weeks of anti infection symptomatic treatment.There was no aggravating infection,septicemia,shock and other complications.Conclusion:Application of MPCN combined with URL in the treatment of calculus obstructive pyonephrosis is a safe and reliable method.