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目的探讨上尿路结石梗阻导致肾积水患者手术治疗解除梗阻后患者的肾功能恢复效果。方法选取2013年1月至2015年6月泌尿外科手术治疗的89例上尿路结石梗阻导致重度肾积水患者进行回顾性分析,收集患者的实验室检查资料,按照肾小球滤过率(GFR)水平分为轻度组、中度组、重度组。对比各组手术前、手术后3个月的各项指标。结果所有患者均采用经皮肾钬激光碎石术治疗。手术后3个月,轻度组、中度组、重度组的GFR、肾实质厚度均较术前显著提高(P<0.05,P<0.01);术前、术后3个月,GFR、肾实质厚度组间比较,轻度组>中度组>重度组,差异均具有统计学意义(P均<0.05);手术后3个月,轻度组、中度组、重度组的尿β_2微球蛋白(β_2MG)、血β_2MG水平均较术前显著降低(P均<0.05);术前、术后3个月,尿β_2MG、血β_2MG组间比较,轻度组<中度组<重度组,差异均具有统计学意义(P均<0.05)。结论对于上尿路结石梗阻导致肾积水患者应早期进行手术治疗,解除尿路梗阻,有助于患者肾功能的恢复。
Objective To investigate the effect of renal function recovery after surgical treatment of patients with hydronephrosis caused by obstruction of upper urinary tract obstruction. Methods From January 2013 to June 2015, 89 cases of upper urinary tract obstruction caused by urologic surgery were retrospectively analyzed. The laboratory data of patients were collected and analyzed according to the glomerular filtration rate GFR) were divided into mild group, moderate group and severe group. Each group before surgery, 3 months after surgery indicators. Results All patients were treated with percutaneous nephrolithium lithotripsy. At 3 months after operation, GFR and renal parenchymal thickness in mild group, moderate group and severe group were significantly increased compared with that before operation (P <0.05, P <0.01). Preoperative and postoperative 3 months, GFR, (P <0.05). At 3 months after operation, the urinary β_2 micro counts in mild group, moderate group and severe group were significantly lower than those in mild group, moderate group and severe group Β_2MG and β_2MG were significantly lower than those preoperatively (all P <0.05). Preoperative and postoperative 3 months, urinary β_2MG and β_2MG were significantly lower in mild group than in moderate group , The differences were statistically significant (P all <0.05). Conclusion For patients with hydronephrosis caused by upper urinary tract obstruction, surgical treatment should be performed early to relieve urinary tract obstruction and help to restore renal function.