尿崩症致上尿路扩张积水10例报告.DOCVIP

PAGE PAGE 7尿崩症导致上尿路积水的诊断与治疗（附10例报告并文献复习）施维凤，付 光，鞠彦合，陈国庆，查丽华，史文博，廖利民 （100068 北京，中国康复研究中心附属北京博爱医院泌尿外科）[摘要] 目的 总结尿崩症导致上尿路积水的临床特点，提高对该疾病的认识。方法 回顾分析2011年1月至2014年7月间，我院收治的10例尿崩症导致双侧上尿路积水患者临床资料，总结其诊治规律。结果 多尿、多饮症状，尿比重、尿渗透压、禁水加压素试验、弥凝诊断性治疗对诊断尿崩症有确诊价值。中枢性尿崩症可通过醋酸去氨加压素类药物，肾性尿崩症可通过利钠利尿类药物治疗，辅助限制饮水、定时排尿，达到减少尿液产生，改善上尿路积水的治疗目的。 结论 该类疾病通常病程较长，误诊率较高，正确诊断该类疾病有助于减少不必要的外科干预。抗利尿治疗可有效改善尿崩症所致的泌尿道扩张和积水。[关键词] 尿崩症；肾积水；诊断；治疗[中图法分类号] [文献标志码] A Diagnosis and treatment of upper urinary tract hydronephrosis caused by Diabetes insipidus (10 cases report and literature review) Shi Weifeng, Fu Guang, Ju Yanhe,Chen Guoqing,Zha Lihua,Shi Wenbo,Liao Limin (Department of urology，China Rehabilitation Research Center，Rehabilitation School of Capital Medical University. Beijing 100068，China)[Abstract] Objective To analyze the clinical characteristics of the patients with diabetes insipidus who presented with dilatation and hydronephrosis of urinary tract, to improve the recognition of the disease. Methods Retrospective analysis the date of 10 cases diabetes insipidus causing bilateral hydronephrosis in our hospital from 2011 Jan to 2014 July, summarize the law of diagnosis and treatment. Results Polyuria, polydipsia symptom, urine specific gravity, urine osmotic pressure, water deprivation vasopressin test, minirin diagnostic treatment have diagnostic value in the diagnosis of diabetes insipidus. Central diabetes insipidus by taking desmopressin acetate tablets, nephrogenic diabetes insipidus through the natriuretic drug therapy, auxiliary restriction of drinking water, timed voiding, change the custom of urination,to reduce the volume of urine produced,and ultimately improve the upper urinary tract dilatation hydrocephalus. Conclusion The results of this kind of disease is usually a longer course of disease, the misdiagnosis rate is high, the correct diagnosis of the disease helps to reduce unnecessary surgical intervention. The medication for diabe