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目的:探讨双侧上尿路结石致肾功能衰竭的急诊处理方法。方法:对于我院1999年10月-2011年10月治疗的44例双侧上尿路结石致肾功能衰竭的急诊处理方法的回顾:34例行输尿管镜下碎石术+双J管置入术引流尿液,其中4例输尿管镜下碎石失败、置双J管困难,改单侧输尿管切开取石术;4例急诊行ESWL;6例一般状况较差首先行血透治疗;结果:43例患者肾功能恢复良好,再经二期手术或ESWL治疗均治愈出院。1例因梗阻时间较长,血透后双侧开放取石解除梗阻,肾功能恢复不满意。结论:双侧上尿路结石致肾功能衰竭基层医院常用的急诊处理方法为:急诊输尿管镜下碎石术、ESWL、血透、急诊开放手术。其中输尿管镜下碎石术+双J管置入术引流尿液解除梗阻为急诊处理双侧上尿路结石致肾衰的简便而安全的方法。
Objective: To investigate the emergency treatment of renal failure caused by bilateral upper urinary calculi. Methods: A retrospective review of 44 patients with renal failure caused by bilateral upper urinary calculi treated in our hospital from October 1999 to October 2011: 34 underwent ureteroscopic lithotripsy + double J-tube placement Operation drainage of urine, including 4 cases of ureteroscopic lithotripsy failure, double J tube difficulties, unilateral ureteral incision and lithotomy; 4 cases ESWL emergency; 6 cases generally poor hemodialysis treatment; Results: Forty-three patients recovered well, and were cured by second-stage surgery or ESWL. A case of obstruction for a long time after hemodialysis on both sides of the open stone lifting obstruction, renal function recovery is not satisfied. Conclusion: The emergency treatment methods commonly used in primary renal failure patients with renal failure due to bilateral upper urinary calculi are emergency ureteroscopic lithotripsy, ESWL, hemodialysis and emergency open surgery. Among them, ureteroscopic lithotripsy + double J-tube insertion and drainage of urine to relieve obstruction is a simple and safe method for emergency treatment of renal failure caused by bilateral upper urinary calculi.