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目的:提高上尿路结石梗阻合并脓肾的早期诊断和治疗水平,挽救患肾功能,减少并发症及肾切除率。方法:回顾性分析26例上尿路结石梗阻合并脓肾患者的临床特点、诊断和治疗。19例行输尿管镜留置双J管引流后二期手术,5例行经皮肾穿刺造瘘引流后二期手术,2例开放手术术中发现脓肾一例保肾,一例行肾切除术。结果:行保肾手术25例,肾切除1例。结论:早期诊断、及时引流、解除梗阻是上尿路结石梗阻合并脓肾保肾治疗的关键。经输尿管镜留置双J管引流及经皮肾穿刺造瘘引流后行二期手术是较好的安全的解除梗阻的方法,可明显减少并发症降低肾切除率,是上尿路结石梗阻合并脓肾的理想治疗方法。
OBJECTIVE: To improve the early diagnosis and treatment of upper urinary tract obstruction complicated with purulent kidney, to save the patients suffering from renal function, reduce the complications and the rate of nephrectomy. Methods: The clinical features, diagnosis and treatment of 26 cases of upper urinary tract obstruction complicated with pus were retrospectively analyzed. 19 cases underwent ureteroscopy double J tube drainage after two operations, 5 cases of percutaneous nephroureterectomy drainage after surgery, 2 cases of open surgery found pus kidney a kidney, a case of nephrectomy. Results: The line of kidney surgery in 25 cases, 1 case of nephrectomy. Conclusion: Early diagnosis, timely drainage, and relieve the obstruction are the key to the treatment of upper urinary calculi obstruction complicated with purulent kidney. The ureteroscopy with double J tube drainage and percutaneous nephrostomy drainage after surgery is a good second phase of surgery to relieve the obstruction of the method can significantly reduce the complications and reduce the rate of nephrectomy is upper urinary tract obstruction with pus The ideal treatment for kidney.