国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
INTERNATIONAL JOURNAL OF UROLOGY AND NEPHROLOGY
2015年
3期
338-340
,共3页
肾功能不全,急性%肿瘤
腎功能不全,急性%腫瘤
신공능불전,급성%종류
Renal Insufficiency,Acute%Neoplasms
目的 探讨恶性肿瘤压迫致急性肾后性肾功能不全的诊断与治疗方法.方法 回顾性分析18例恶性肿瘤压迫致肾后性肾功能不全患者的临床资料.男11例,女7例,年龄17～ 80岁,平均56.7岁.原发病:胃癌2例,直肠癌3例,乙状结肠癌3例,肾癌1例,前列腺肉瘤1例,前列腺癌3例,宫颈癌5例.入皖时SCr 431.9～ 1078.5μmol/L,平均680±177 μumol/L;BUN11.6～44.1mmol/L,平均22.3±6.9mmol/L.15例行输尿管镜下输尿管支架置入术,其中2例置管失败改行肾造瘘术(双侧1例,单侧1例);输尿管皮肤造瘘术3例,均为双侧.结果 手术前后BUN、SCr、血清钾及24h尿量比较差异均有统计学意义(P＜0.01);随访3个月～3年,恢复到正常9例,氮质血症但肾功能明显改善2例,其中8例术后需定期更换双J管;尿毒症2例需定期血液透析;死亡5例.结论 恶性肿瘤压迫致肾后性肾功能不全患者的治疗方法主要包括输尿管镜下输尿管支架置入术、肾造瘘术、输尿管皮肤造瘘术;尽早明确梗阻原因,选择恰当的手术方式及时解除尿路梗阻是治疗关键.
目的 探討噁性腫瘤壓迫緻急性腎後性腎功能不全的診斷與治療方法.方法 迴顧性分析18例噁性腫瘤壓迫緻腎後性腎功能不全患者的臨床資料.男11例,女7例,年齡17～ 80歲,平均56.7歲.原髮病:胃癌2例,直腸癌3例,乙狀結腸癌3例,腎癌1例,前列腺肉瘤1例,前列腺癌3例,宮頸癌5例.入皖時SCr 431.9～ 1078.5μmol/L,平均680±177 μumol/L;BUN11.6～44.1mmol/L,平均22.3±6.9mmol/L.15例行輸尿管鏡下輸尿管支架置入術,其中2例置管失敗改行腎造瘺術(雙側1例,單側1例);輸尿管皮膚造瘺術3例,均為雙側.結果 手術前後BUN、SCr、血清鉀及24h尿量比較差異均有統計學意義(P＜0.01);隨訪3箇月～3年,恢複到正常9例,氮質血癥但腎功能明顯改善2例,其中8例術後需定期更換雙J管;尿毒癥2例需定期血液透析;死亡5例.結論 噁性腫瘤壓迫緻腎後性腎功能不全患者的治療方法主要包括輸尿管鏡下輸尿管支架置入術、腎造瘺術、輸尿管皮膚造瘺術;儘早明確梗阻原因,選擇恰噹的手術方式及時解除尿路梗阻是治療關鍵.
목적 탐토악성종류압박치급성신후성신공능불전적진단여치료방법.방법 회고성분석18례악성종류압박치신후성신공능불전환자적림상자료.남11례,녀7례,년령17～ 80세,평균56.7세.원발병:위암2례,직장암3례,을상결장암3례,신암1례,전렬선육류1례,전렬선암3례,궁경암5례.입환시SCr 431.9～ 1078.5μmol/L,평균680±177 μumol/L;BUN11.6～44.1mmol/L,평균22.3±6.9mmol/L.15례행수뇨관경하수뇨관지가치입술,기중2례치관실패개행신조루술(쌍측1례,단측1례);수뇨관피부조루술3례,균위쌍측.결과 수술전후BUN、SCr、혈청갑급24h뇨량비교차이균유통계학의의(P＜0.01);수방3개월～3년,회복도정상9례,담질혈증단신공능명현개선2례,기중8례술후수정기경환쌍J관;뇨독증2례수정기혈액투석;사망5례.결론 악성종류압박치신후성신공능불전환자적치료방법주요포괄수뇨관경하수뇨관지가치입술、신조루술、수뇨관피부조루술;진조명학경조원인,선택흡당적수술방식급시해제뇨로경조시치료관건.
Objectives To explore the clinical analysis of diagnosis and treatment of post-renal acute renal failure caused by malignant tumor compression.Methods 18 cases were retrospectively analyzed from June 2009 to January 2014.There were 11 males and 7 females with a mean age of 56.7 years old.The primary disease include stomach,rectal,sigmoid colon,cancer,prostate and cervical cancer.The serum contents of creatinine and urea nitrogen were (680 ± 177) umol/L and (22.3±6.9) mmol/L,respectively.15 cases performed retrograde placement of double-J ureteral stent,of which 2 cases performed percutaneous nephrostomy.3 cases performed cutaneous ttreterostomy.Results There were significant differences in serum creatinine,urea nitrogen,sertum potassium,and urine volume between pre-operation and post operation (P＜0.01).The follow-up was ranged from3 months to3 years.Among the 18 cases,9 cases have renal function return to normal nitrogen qualitative hematic disease but renal function improved significantly in 2 cases,of which 8 cases of postoperative need routine replacement of double J tube;2 cases need regular hemodialysis;5 cases the patients died.Conclusions Treatment for post-renal acute renal failure caused by malignant tumor compression includes retrograde placement of double-J ureteral stent,percutaneous nephrostomy,and cutaneous ureterostomy.It is important to define obstruction reason and part and remove the obstruction early for resume the renal function.
