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目的探讨急性梗阻性脓肾的病理特点及保肾手术治疗的价值。方法对41例一期取石加肾造瘘或输尿管放置双J管的急性梗阻性脓肾患者的临床资料进行分析。本组41例,男28例,女13例;平均年龄38岁。左侧19例,右侧22例。发病时间3~18 d,平均7 d。结果术后随访36例,患肾功能恢复或部分恢复33例(91.7%),术后1年发生肾萎缩3例(8.3%),复发结石5例。结论发病时间较短、梗阻解除后肾皮质血运改善的急性梗阻性脓肾保肾手术是可行的,局部肾皮质厚薄并非保留患肾的主要依据。
Objective To investigate the pathological features of acute obstructive pus and the value of kidney-preserving surgery. Methods The clinical data of 41 patients with acute obstructive pus with double J tube placed in ureter and ureterostomy or ureter were analyzed. The group of 41 patients, 28 males and 13 females; mean age 38 years old. 19 cases on the left and 22 cases on the right. Onset time 3 ~ 18 d, an average of 7 d. Results Thirty-six patients were followed up, and 33 cases (91.7%) had renal function recovery or partial recovery, 3 cases (8.3%) had renal atrophy one year after operation, and 5 cases had recurrent stones. Conclusions Acute obstructive pustular kidney surgery with shorter onset time and improved renal cortical blood supply after obstruction relief is feasible. The local renal cortex thickness is not the main basis for preserving the kidney.