摘要
目的探讨输尿管镜钬激光碎石治疗双侧输尿管结石合并急性梗阻性’肾功能不全的疗效。方法回顾性分析19例双侧输尿管结石患者资料，均采用输尿管镜下钬激光碎石解除梗阻，术中留置双J管，并比较手术前及术后血Scr、BUN的变化，观察肾功能恢复及出院时间情况。结果19例均一期行输尿管镜钬激光碎石术，术前Scr（243～834）μmol／L，平均（458．34-59．1）μmol／L，术前BUN（16．3～26．1）mmol，平均（20．7±3．4）mmol；Scr、BUN于术后ld开始下降，平均Scr为（217．36±28．3）p,mol／L，平均BUN（13．8±3．2）mmol；术后1周Scr（58～131）μmol/L，平均（86．2±16．9）μmol／L，BUN（3．5～7．0）mmol/L，平均（5．5±1．1）mmol，差异有统计学意义（P=0．000）。术后3～6天出院，平均（5．0±2．2），随访3—6个月，结石无残留，肾功能正常。结论输尿管镜钬激光碎石、取石是治疗双侧输尿管结石合并肾功能不全安全有效的方法，具有创伤小、恢复快等优点。
Objective To investigate the clinical efficacy of holmium ：YAG laser lithotripsy for the treatment of acute renal failure caused by bilateral ureteral calculi obstruction under ureteroscope. Methods A retrospective study was made on 19 cases with acute renal failure caused by ureteral calculi obstruction in bilateral upper urinary tract, who underwent transureteroscopic Holmium：YAG laser lithotripsy with one - stage treatment indwelling two J tube simultaneously. Compare the parameters of Scr, BUN before and after operation; Observe the recover of renal function and the discharge time. Results All of cases, operation was successful. Before operation Scr （243 - 834） μmol/L,mean （458.3 ±59.1） μmol/L; BUN （16.3 -26. l）mmol,mean （20.7 ±3.4） mmol. 1 day after operation Scr and BUN begin decrease, the mean Scr （217.36 ± 28.3 ）μmol/L, BUN （ （ 13.8 ± 3.2） mmol. 1 week after operation Scr （58 - 131 ） μmol/L,mean （86. 2 ± 16.9） μmol/L,BUN （3.5 -7.0） mmol/L,mean （5.5 ± 1.1 ） mmol, with statistical difference （p = 0. 000）. They were discharged 3 - 6 days after operation, mean （5.0±2.2 ）. Mean followup period was 6 months （3 - 6 months） and showed no remain of calculi, with normal renal function. Conclusion Transureteroscopic Holmium：YAG laser lithotripsy is a safe and effective procedure in the management of bilateral ureteral calculi with acute renal failure, it has the advantage of less damage, rapid recovery.
出处
《现代医院》
2014年第4期32-33,36,共3页
Modern Hospitals
关键词
输尿管结石
肾功能不全
输尿管镜
钬激光
Ureteral calculi, Renal failure, Ureteroscopy, Holmium
YAG laser
