上尿路梗阻急性肾功能衰竭治疗

Treatment of acute renal failure of upper urinary obstruction

目的:探讨急性上尿路梗阻急性肾功能衰竭的急诊处理。方法 回顾上尿路急性梗阻急性肾功能衰竭病例41例,病程1～9天,肾盂急性造瘘者2例。输尿管逆行插管通过梗阻后换置双“J”管行Eswl治疗6例,手术33例,结果 21例均在院4天内解除梗阻。17例尿量增加。尿毒症状消失,BUN,CR恢复正常。9例因梗阻时间均在7天以上,BUN降至8～11mmol/l,Cr降至150～170umol/l。结论 上尿路梗阻急性肾功能衰竭应尽早诊断及时解除梗阻。早期应用有效。肾毒性低的抗生素防治并发症。

Objective To summarize emergency treatment for acute renal failure of upper urinary obstruction Methods Look back 41 cases patients of acute renal failure of upper urinary obstruction, course of diseases 1 to 9 days, 2 cases make fistula in calyx. 6 cases with indwelling ureteral stent retrogradely stent retrogradely and change Eswl .Results 21 cases patient all unchain obstruction in 4 days, 17 cases urine increase, uraemia mend, BUN and Cr all in normal range, 9 cases patients upper urinary obstruction 7 days and BUN is 8～11mmol/L and Cr is 150～170umol/L. Conclusions The principles of management for this acute renal failure of upper urinary obstruction should be diagnosing early and promptly, releasing obstruction as soon as possible. and antibi- otic prevention and cure syndrome.