【摘要】 目的　探讨微创外科技术在急诊处理梗阻性急性肾功能衰竭 (肾衰 )的手术治疗方法和临床价值。方法　运用输尿管镜检、气压弹道碎石、微创经皮肾镜取石、输尿管狭窄内切开、留置双J管等微创外科技术急诊治疗梗阻性急性肾功能衰竭。术后随访 1～ 12个月 ,追踪测定BUN、SCr。结果　 4 3例病人均成功地解除输尿管梗阻并留置双J管 ,其中 37例经尿道逆行上镜手术 ,6例改行微创经皮肾穿刺顺行入镜手术 ,无腔内手术失败改开放手术的病例。手术时间 15～ 180min ,平均 75min。 4 2例疗效满意 ,1例死亡。结论　微创外科技术急诊处理梗阻性急性肾功能衰竭 ,具有创伤小、疗效确切、安全可靠 ,能同时处理双侧输尿管梗阻病变 ,病人术后恢复快的优点 ,可作为首选治疗方法。同时要重视对多器官功能障碍综合征的预防。更多还原

【Abstract】 Objective To explore the surgical means and clinical value of emergency treatment of obstructive acute renal failure by means of minimally invasive endoscopic manipulation.Methods We used ureteroscopy,air pressure lithotripsy,minimally invasive percutaneous nephrolithotomy,ureter straitness intestine carve and double J catheter placing for the emergency treatment of obstructive acute renal failure.The patients were followed up for 1～12 months.Results 43 patients,surgery were successful,all cases were cured without open surgery.Operation time was 15～180min,averaging 75min.42 patients proved of curative effect,after 2 dyas operation 1 patient died.Conclusion Endoscopic management has the advantages of minimal invavsion,safety,quick recovery and bilateral ureteral obstruction could be dealt with simultaneously.Instant endoscopic is means firsts elect in the treatment of obstructive acute renal failure,but one need to pay attention to prevent of multiple organ dysfunction syndrome.更多还原