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目的探讨婴幼儿多发性上尿路结石梗阻致急性肾功能衰竭的急诊处理方法及疗效。方法对婴幼儿多发性上尿路结石梗阻致急性肾功能衰竭312例的临床资料进行回顾性分析及随访。双肾结石41例,双侧输尿管结石97例,肾结石并输尿管结石171例,一侧肾或输尿管结石并对侧肾萎缩2例,孤立肾及输尿管上段结石1例。肌酐平均720μmol/L,结石直径0.5~2.8 cm。结果其中保守治疗有效22例,急诊开放手术治疗284例。术后随访时间平均6个月,随访指标为24小时尿量、肾功、生存率、泌尿系CT等。结论对于婴幼儿多发性上尿路结石梗阻致急性肾功能衰竭,应采取急症手术治疗,及时解除梗阻,恢复肾功能。
Objective To investigate the emergency treatment of acute renal failure caused by multiple upper urinary tract obstruction in infants and young children. Methods The clinical data of 312 cases of acute renal failure caused by multiple upper urinary tract obstruction in infants and young children were retrospectively analyzed and followed up. 41 cases of bilateral renal calculi, 97 cases of bilateral ureteral calculi, 171 cases of kidney stones and ureteral calculi, 1 case of renal or ureteral calculi with contralateral renal atrophy, 1 case of isolated kidney and upper ureteral calculi. Creatinine average 720μmol / L, stone diameter 0.5 ~ 2.8cm. Results Among them, 22 cases were conservatively treated and 284 cases were treated by emergency open surgery. The average duration of follow-up was 6 months. The follow-up index was 24-hour urine output, renal function, survival rate and urinary CT. Conclusions For acute renal failure caused by multiple upper urinary tract obstruction in infants and young children, urgent surgical treatment should be taken to relieve the obstruction in time and restore renal function.