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患者,男,46岁。住院号:23678。间断发作左侧腰部疼痛1年,伴肉眼血尿。疼痛发作伴无尿,疼痛向会阴部放射,即到某医院就诊,经拍腹平片及双肾区B型超声检查,诊为左输尿管结石肾积水,可疑“孤立肾”。给以经膀胱镜左输尿管逆行插管引流尿液,症状得到缓解。于入院前1天导管脱出后仍无尿伴尿毒症而转入我院。泌尿系检查:右肾未触及,左肾可触到下极并有叩击痛、尿常规红细胞(+)、BUN63mg%。腹平片:可见左输尿管上段有一1.5×1.0cm致密结石阴影。肾图检查:左肾呈急性梗阻图形,右肾呈无功能图形。B型超声:左肾外形增大伴轻度肾盂积水,右肾未探及。排泄性尿路造影:左输尿管上段结石,有肾盂肾盏未显影。膀胱镜检查并行左输尿管逆行插管,左输尿管口清晰可见,但无喷尿现象,未见右侧输尿管开口,左输尿管逆行
Patient, male, 46 years old. Hospital number: 23678. Intermittent left lumbar pain for 1 year, with gross hematuria. Pain episodes with anuria, pain to the perineal radiation, that is, to a hospital for treatment, after filming and kidney area B-mode ultrasound, diagnosed as left ureteral calculi hydronephrosis, suspicious “isolated kidney.” Left ureter retrograde cystoscopy catheter drainage of urine, the symptoms were alleviated. One day before admission, there was no urine with uremia after catheterization and transferred to our hospital. Urinary tract examination: the right kidney is not touched, the left kidney can reach the lower pole and percussion pain, urinary RBC (+), BUN63mg%. Abdominal plain film: visible upper ureter with a 1.5 × 1.0cm dense stone shadow. Renogram examination: the left kidney showed an acute obstruction pattern, the right kidney showed no functional pattern. B-mode ultrasound: enlarged left kidney with mild hydronephrosis, the right kidney is not explored. Excretory urography: upper left ureteral calculi, renal pelvis calyx did not develop. Cystoscopy parallel left ureter retrograde intubation, left ureteral orifice is clearly visible, but no squirting, no ureteropelvic opening, retrograde left ureter