目的　探讨小儿上尿路结石所致肾功能不全保留肾脏手术的适应证及疗效。　方法　对 118例上尿路结石伴肾功能不全患儿的病理及临床资料进行回顾性分析。　结果　 118例患儿 88个肾及 30根输尿管切开取石术及肾造瘘术 ,痊愈 115例 ,治愈率 97.5 % ,死亡 3例 ,死亡率 2 .5 % ,术后无发生上尿路狭窄者。　结论　小儿上尿路结石所致急慢性肾功能不全 ,早期诊断 ,尽早解除梗阻是保护及改善肾功能的关键 ,根据病史、体征、患侧肾皮质厚度及肾功能情况 ,有无感染等综合判断是保留肾脏手术成功的重要条件。 Objective To investigate the indications and curative effects of renal insufficiency due to upper urinary tract calculi in children. Methods The pathology and clinical data of 118 cases of upper urinary tract calculi with renal insufficiency were retrospectively analyzed. Results A total of 118 renal tubules and ureterostomy were performed in 118 children, and 115 cases were cured. The cure rate was 97.5%, the death rate was 3 and the mortality rate was 2.5%. No upper urinary tract stenosis occurred after operation By. Conclusions Pediatric upper urinary tract stones caused by acute and chronic renal insufficiency, early diagnosis, early obstruction is the key to protect and improve renal function, according to history, signs, ipsilateral cortical thickness and renal function, with or without infection and other comprehensive judgment Is an important condition for the success of renal surgery.