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目的:探讨上尿路梗阻致肾包膜下积血或积脓类似病例的诊断及治疗方法。方法:回顾性分析3例上尿路梗阻致肾包膜下积血或积脓患者临床资料:3例患者均行开放手术探查,1例清除陈旧性积血后行肾盂输尿管离断成形术,1例清除血肿后行肾切除术,1例清除积脓引流后留置肾造瘘管待Ⅱ期行经皮肾镜碎石取石术。结果:全部患者均恢复良好,无远期并发症出现。结论:上尿路梗阻致肾包膜下积血或积脓发生机制不明,影像学诊断中CT较为敏感,处理应积极手术探查,清除血肿及外科引流,解除梗阻或留置肾造瘘管待Ⅱ期手术。
Objective: To investigate the diagnosis and treatment of similar cases of renal subcapsular hemorrhage caused by upper urinary tract obstruction. Methods: The clinical data of 3 patients with renal subcapsular hemorrhage or pyometra caused by upper urinary tract obstruction were retrospectively analyzed. Three patients underwent open surgery exploration, one was treated with ureteropelvic pyeloplasty after removing old hemorrhage, One patient underwent nephrectomy after removing the hematoma, and one patient had indwelling nephrostomy after removal of empyema to be treated by percutaneous nephrolithotomy. Results: All patients recovered well without any long-term complications. Conclusion: The pathogenesis of renal subcapsular hemorrhage or empyema caused by obstruction of the upper urinary tract is unclear. CT is more sensitive in imaging diagnosis. Surgical exploration should be performed to clear the hematoma and surgical drainage, to relieve obstruction or indwelling renal fistula. surgery.