尿崩症致上尿路扩张积水10例报告.docVIP

PAGE PAGE 5 DOI：10.16016/j.1000-5404.201410045 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 hydronephrosis caused by diabetes insipidus (10 cases of reports and literature review) Shi Weifeng, Fu Guang, Ju Yanhe, Chen Guoqing, Zha Lihua, Shi Wenbo, Liao Limin (Department of Urology, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China) [Abstract] Objective To analyze the clinical characteristics of patients with hydronephrosis caused by diabetes insipidus. Methods Clinical data from 10 patients with diabetes insipidus causing bilateral ureter dilatation and bilateral hydronephrosis in our hospital from 2011 January to 2014 July were retrospectively analyzed, and the law of diagnosis and treatment was summarized. Results Polyuria, polydipsia symptom, urine specific gravity, urine osmotic pressure, water deprivation vasopressin test, and minirin diagnostic treatment had diagnostic values for diabetes insipidus. Central diabetes insipidus was treated with desmopressin acetate tablets, and nephrogenic diabetes insipidus was treated with natriuretic drugs plus drinking water restriction and timed urination to reduce the volume of the produced urine and ultimately improve the hydronephrosis. Conclusion Diabetes insipidus usually has longer course of disease and high misdiagnosis rate, and correct diagnosis helps to reduce unnecessary surgical intervention. Antidiuretics are effective for alleviating urinary tract dilatation and hydronephrosis caused by diabetes insipidus. [Key words] diabetes