CAJ | 학술논문

目的：观察独肾急性上尿路梗阻并脓毒性休克、急性肾功能衰竭微创外科治疗效果。方法对我院收治的采用微创外科治疗的独肾急性上尿路梗阻并脓毒性休克、急性肾功能衰竭28例的临床资料进行回顾性分析。结果本组行微创经皮肾穿刺造瘘术17例,输尿管逆行插管11例。28例均及时解除上尿路梗阻,全身情况得到明显改善,肾功能有不同程度恢复,仅3例行血液透析1次,2例予长期留置肾造瘘管引流。28例微创外科治疗后血白细胞计数、血尿素、血肌酐及尿量均较治疗前明显改善,差异均有统计学意义(P<0.01)。结论积极抗感染,纠正休克和水、电解质、酸碱平衡紊乱同时,行微创经皮肾穿刺造瘘术或输尿管插管引流术缓解独肾急性上尿路梗阻效果满意。
목적：관찰독신급성상뇨로경조병농독성휴극、급성신공능쇠갈미창외과치료효과。방법대아원수치적채용미창외과치료적독신급성상뇨로경조병농독성휴극、급성신공능쇠갈28례적림상자료진행회고성분석。결과본조행미창경피신천자조루술17례,수뇨관역행삽관11례。28례균급시해제상뇨로경조,전신정황득도명현개선,신공능유불동정도회복,부3례행혈액투석1차,2례여장기류치신조루관인류。28례미창외과치료후혈백세포계수、혈뇨소、혈기항급뇨량균교치료전명현개선,차이균유통계학의의(P<0.01)。결론적겁항감염,규정휴극화수、전해질、산감평형문란동시,행미창경피신천자조루술혹수뇨관삽관인류술완해독신급성상뇨로경조효과만의。
Objective To explore the effect of minimally invasive surgery in treatment of single-kidney patients with acute upper urinary tract obstruction complicated by septic shock and acute renal failure. Methods 28 single-kidney patients with acute upper urinary tract obstruction complicated by septic shock and acute renal failure underwent minimally invasive treatment in our hospital, and the clinical data was retrospectively analyzed. Results Among these patients, 17 cases were operated with minimally invasive percutaneous nephrostomy drainage, 11 cases were treated by placing ureteral stent retro-gradely under ureteroscopy. All cases removed the upper tract obstruction in time, body states also were effectively improved, and patients' renal function recovered to different extent. There were 3 cases needing hemodialysis 1 time, and 2 cases treated with long-term indwelling renal fistula drainage. White blood cell count, blood urea nitrogen, serum creatinine and urine vol-ume in all patients were significantly improved post-operation when compared with those pre-operation (P<0. 01). Conclu-sion It is crucial to operate minimally invasive percutaneous nephrostomy and retrograde ureteral catherer placing besides an-tibiotic therapy, correction of shock and electrolytic equilibrium for single-kidney patients with acute upper urinary obstruction complicated by septic shock and acute renal failure.