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1、微创手术治疗上尿路结石所致急性梗阻性肾功能不全首都医科大学宣武医院，泌尿外科，北京100053【摘要】目的：探讨微创手术（输尿管镜或经皮肾镜）治疗上尿路结石所致急性梗阻性肾功能不全的临床效果。方法：随机选取60例上尿路结石所致急性梗阻性肾功能不全的患者，分成两组，实验组30例患者上尿路结石致急性梗阻性肾功能衰竭患者釆用微创手术。对照组30例患者采用切开取石术（传统开放手术或腹腔镜手术）治疗。术后3月后测量血清肌酐、血尿素氮、尿酸以及24h尿量与治疗前的各项数据进行对比。结果：均成功解除尿路梗阻，实验组30例患者，结石取净率94.4%;对照组30例患者中，结石取净率为91.7%
2、,无严重并发症发生。3月后，实验组肾功能恢复正常27例，3例仍有氮质血症，但肾功能明显改善。对照组肾功能恢复正常者23例，7例扔有氮质血症。结论：微创手术治疗上尿路结石所致急性肾功能衰竭具有微创、安全效果好等优点，具有广泛的临床推广价值。【关键词】上尿路结石急性阻塞性肾功能衰竭微创取石MinimallyinvasivesurgicaltreatmentofacuteobstructiverenalfailurecausedbyupperurinarystonesChenXiao-song,WangSheng-han,CuiXin,LiJin,SunYun-cheng,OuTo
3、ng-wen,XuJian-jun（DepartmentofUrology,XuanwuHospital,CapitalMedicalUniversity,Beijing100053,China）"Abstract"Objective:toinvestigatetheclinicaleffectofminimallyinvasivesurgicaltreatmentofacuteobstructiverenalfailurecausedbyupperurinarytractcalculiin.Methods:60patients,withacuteupperurinaryca
4、lculiandobstructiverenalfailure,weredividedintotwogroups.The30patients,intheexperimentalgroup,withacuteobstructiverenalfailurecausedbyupperurinarycalculi,weretreatedwithminimallyinvasivesurgery,suchasureteroscopeandpercutaneousnephrolithotomy.The30patientsinthecontrolgroupweretreatedwithure
5、terolithotomy(traditionalopensurgeryorlaparoscopicsurgery.3monthslater,measuringserumcreatinine,bloodureanitrogenanduricacid,and24hurineoutput,comparewiththedatabeforetreatment.Result:Inallpatients,theurinarytractobstructionwassuccessfullyrelieved.Intheexperimentalgroup,Thestone-freeratewas
6、94.4%;Inthecontrolgroup,stonefreeratewas91.7%,withoutseriouscomplications.After3months,27casesintheexperimentalgroupobtainednormalrenalfunction.3casesstillwithazotemia,butkidneyfunctionimprovedsignificantly.Normalrenalfunctionwasachieved23patientsinthecontrolgroup,except7casesazotemia.Concl
7、usion:Intreatmentofacuterenalfailurecausedbyupperurinarytractcalculi,theminimallyinvasivesurgeryisminimallyinvasivewiththeadvantagesofgoodsecurity,withawiderangeofclinicalvalue."Keywords”upperurinarycalculi,acuteobstructiverenalfailure,minimallyinvasivel
