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上尿路梗阻性肾功能不全22例,孤立肾结石1例;双侧肾结石14例,合并一侧输尿管结石4例,双侧输尿管结石2例;单纯输尿管结石3例;先天性肾盂输尿管连接部狭窄1例;直肠癌、宫颈癌盆腔浸润输尿管共3例。行膀胱镜输尿管插管8例,后分别择期行肾切开取石或输尿管切开取石术,2例插管失败后急诊行输尿管切开取石;双肾造瘘5例,其中2例择期行肾盂、肾实质切开取石术;另外7例未行肾造瘘引流术者分别作择期肾切开取石4例或输尿管切开取石术3例;17例血Cr、BUN正常出院;4例血Cr、BUN稍高于正常值。急性梗阻者应积极采取外科治疗,行输尿管逆行插管、肾穿刺造瘘或开放手术解除梗阻;慢性梗阻者宜首选透析治疗,待全身情况改善后择期手术治疗。
Upper urinary tract obstruction of renal insufficiency in 22 cases, isolated kidney stones in 1 case; bilateral kidney stones in 14 cases, combined with ureteral calculi in 4 cases, bilateral ureteral calculi in 2 cases; simple ureteral calculi in 3 cases; congenital pyeloureteric junction Department of stenosis in 1 case; rectal cancer, cervical cancer pelvic infiltration ureter in 3 cases. Cystoscopy ureter intubation in 8 cases, respectively, after elective nephrectomy or ureteral incision lithotomy, 2 cases of failed emergency catheter ureterotomy lithotripsy; double nephrostomy in 5 cases, of which 2 cases elective renal pelvis , Renal parenchyma cut lithotomy; the other seven cases without renal fistula draining were taken for elective kidney incision in 4 cases or ureterolithotomy in 3 cases; 17 cases of blood Cr, BUN normal discharge; 4 cases of blood Cr , BUN slightly higher than normal. Acute obstruction should be actively taken surgical treatment of retrograde ureteral catheterization, renal puncture fistula or open surgery to relieve obstruction; chronic obstruction should dialysis treatment of choice, until the general condition of the elective surgery.