上尿路梗阻性肾功能衰竭的急诊处理

Emergency Management of Renal Failure Caused by Acute Obstruction of Upper Urinary Tract

目的总结上尿路梗阻所致肾功能衰竭的急诊处理。方法回顾分析 5 8例上尿路梗阻性肾功能衰竭患者的病因以及急诊处理方法。结果5 5例肾功能完全恢复 ,2例肾功能有明显改善 ,1例肾功能未恢复而行规律血液透析。结论膀胱镜下逆行放置双J管引流可以迅速解除梗阻 ,是治疗上尿路梗阻性肾功能衰竭的首选方法 ,若置管失败 。

ObjectivesTo summarize the emergency management of renal failure(RF) caused by acute obstruction of upper urinary tract . Methods The cause and emergency management in fifty eight patients with acute obstructive RF of upper urinary tract were analyzed retrospectively. Results Renal function of fifty five cases restored to normal completely and that of two cases improved remarkably after follow up for three months ,while one case became worse and was subjected to regular hemodialysis. ConclusionDrainage via double J catheter by retrograde insertion under cystoscope can quickly relieve obstruction of upper urinary tract, so it is the first choice for treatment of acute obstructive RF in upper urinary tract . Percutaneous nephrostomy under B ultrasound guide or exploratory operation may be selected if insertion of double J catheter fails .