急性上尿路梗阻性无尿的应急治疗.docVIP

精品论文 参考文献 急性上尿路梗阻性无尿的应急治疗 湖南省岳阳市一人民医院泌尿外科 湖南岳阳 414000 【摘 要】目的：分析急性上尿路梗阻性无尿的应急治疗效果。方法：选取我院于2013年8月～2015年10月期间，临床确诊的62例急性上尿路梗阻性无尿患者作为研究对象，所有患者均采取应急治疗，首选输尿管插管，以单侧插双J管或一侧插管、另一侧行经皮肾穿刺造瘘术（PCN术)；其次为在超声引导下行PCN术；在疗效不佳的情况下，采取单侧开放性肾造瘘或输尿管腹壁造口；对于高钾血症、尿毒症患者可采取透析治疗，配合解痉、镇痛、纠正水盐电解质酸碱紊乱、预防感染等治疗；综合评价患者的应急治疗效果。结果：62例急性上尿路梗阻性无尿患者在应急治疗中，54例患者在应急治疗后解除梗阻，梗阻解除率为87.10%；8例患者梗阻解除失败，但Scr、Ccr、BUN水平显著下降，均成功采取病因治疗后，12小时尿量、24小时尿量均显著增多；所有患者均无上尿路感染发生，肾功能恢复良好，尿潴留病情显著缓解；治疗前后，Scr、Ccr、BUN、12小时尿量、24小时尿量均具有显著性差异（P＜0.05)。结论：急性上尿路梗阻性无尿的应急治疗方法依次为输尿管插管、PCN术、开放性肾造瘘、输尿管腹壁造口，解除上尿路梗阻的效果明显，恢复肾功能，显著改善患者的预后，为采取病因治疗而创造条件。 【关键词】急性上尿路梗阻性无尿；应急治疗；效果 [Abstract]Objective：To analyze the acute urinary tract obstruction of urine without emergency treatment.Methods：A hospital in August 2013 - October 2015 period，62 patients with clinically diagnosed acute urinary tract obstruction in patients with anuria the study，all patients were taken to emergency treatment，the preferred ureteral catheterization，unilateral insert one side of the double J tube or cannula，the other side of the gastrostomy percutaneous nephrolithotomy（PCN surgery)；followed by ultrasound-guided PCN surgery；in the case of poor efficacy，to take unilateral openness nephrostomy or ureter abdominal stoma；for hyperkalemia，uremic patients can take dialysis treatment，with antispasmodic，analgesic，correct water and salt electrolyte acid-base disorders，prevention of infection and other treatment；comprehensive evaluation of the emergency treatment of patients.Results：62 cases of acute urinary tract obstruction in patients with anuria emergency treatment，54 patients in the emergency treatment to relieve the obstruction，the obstruction is relieved rate of 87.10%；8 patients fail obstruction is relieved，but Scr，Ccr，BUN levels significantly decline，were successfully taken the cause treatment after 12 hours urine 24 hours urine was significantly increased；all patients had upper urinary tract infection，renal function recovered well，urinary retention c