上尿路结石致急性肾功能衰竭临床治疗研究.docVIP

上尿路结石致急性肾功能衰竭的临床治疗研究 　　[摘要] 目的 探讨上尿路结石致急性肾功能衰竭的有效治疗方法，为今后的诊治研究提供参考。 方法 选取2013年11月～2014年11月在河北工程大学附属医院就诊的67例上尿路结石致急性肾功能衰竭患者，按就诊顺序和个人意愿分为采取经皮肾镜钬激光碎石术治疗的观察组（33例）和采取双定位体外碎石术治疗的对照组（34例），记录并比较两组患者手术前后血肌酐和尿素氮水平及术后肾功能、尿量恢复时间。 结果 两组患者术后血肌酐和尿素氮水平均较术前降低，差异有统计学意义（P 0.05）。对照组患者术后肾功能和尿量恢复时间分别为（7.98±1.32）、（7.23±1.54）d，观察组术后肾功能和尿量恢复时间分别为（6.14±1.99）、（6.38±1.33）d，差异有高度统计学意义（P 0.01）。 结论 经皮肾镜钬激光碎石术和双定位体外碎石术在临床指标方面无明显区别，但对于尿道较窄，且与相关组织存在严重粘连、结石存在时间较长的患者，应首选经皮肾镜钬激光碎石术，以提高术后恢复时间，最大限度保证结石的完全清除。 　　[关键词] 上尿路结石；急性肾功能衰竭；经皮肾镜钬激光碎石术 　　[中图分类号] R692.4 [文献标识码] A [文章编号] 1673-7210（2016）01（c）-0075-04 　　Clinical treatment study on acute renal failure caused by upper urinary tract calculi 　　SHI Yunguang DUAN Dongpeng WANG Hongxia WANG Honghu 　　Department of Emergency， Affiliated Hospital of Hebei University of Engineering， Hebei Province， Handan 056000， China 　　[Abstract] Objective To explore the effective therapy for acute renal failure caused by upper urinary calculi， and to provide reference for the study on diagnosis and treatment of the future. Methods 67 cases of acute renal failure patients caused by upper urinary calculi from November 2013 to November 2014 in Affiliated Hospital of Hebei University of Engineering were selected， and they were divided into observation group （33 cases） adopted by percutaneous nephrolithotomy with holmium laser lithotripsy and control group （34 cases） took double positioning in vitro lithotripsy according to their order of treatment and individual will. Serum creatinine and urea nitrogen levels before and after surgery， postoperative renal function and urine output recovery time between two groups were recorded and compared. Results After surgery， serum creatinine and urea nitrogen levels in two groups were lower than those before surgery， with statistical differences （P 0.05）. Postoperative renal function and urine output recovery time in control group was （7.98±1.32）， （7.23±1.54）d respectively， postoperative renal function and urine output recovery time