【摘要】 目的 探讨上尿路结石相关自发性肾破裂的临床特点及诊治经验。方法 回顾性分析2021年11月至2024年9月重庆医科大学附属第二医院收治的6例上尿路结石相关自发性肾破裂患者的临床资料，分析患者的基本临床特点、诊治方案及治疗结局。结果 6例患者中，5例伴有患侧腰腹疼痛、畏寒发热入院。其中3例患者行输尿管支架置入联合肾周血肿穿刺引流治疗后病情好转出院，1例患者行肾动脉栓塞联合肾周血肿穿刺引流治疗后好转出院；1例患者经保守治疗后好转；1例患者行输尿管支架置入治疗，但该例患者病情危重，基础疾病多，经泌尿外科、重症医学科等多学科联合诊治后，治疗无效死亡。结论 上尿路结石相关自发性肾破裂相对少见，常伴有严重泌尿道感染，应根据患者病情决定相应治疗方法，早期诊断和外科干预可以给患者带来良好的预后。更多还原

【Abstract】 Objective To examine the clinical characteristics, diagnostic approaches, and treatment strategies for spontaneous renal rupture associated with upper urinary tract calculi. Methods A retrospective analysis was conducted on the clinical data of six patients diagnosed with spontaneous renal rupture related to upper urinary tract calculi. The patients were admitted to the Second Affiliated Hospital of Chongqing Medical University between November 2021 and September 2024. The study focused on evaluating the patients’ basic clinical characteristics, diagnostic processes, treatment modalities, and clinical outcomes. Results Among the six patients with spontaneous renal rupture associated with upper urinary tract calculi, five presented with symptoms of flank pain, chills, and fever upon hospital admission. Of these, three patients showed improvement following a combination of ureteral stent placement and perirenal puncture drainage. One patient improved after undergoing renal artery embolization in conjunction with perirenal puncture drainage.One patient demonstrated improvement following conservative management. Another patient, who underwent ureteral stent implantation, was in critical condition due to multiple comorbidities. Despite intervention from multidisciplinary treatment involving urology and intensive care departments, the patient’s condition did not improve and resulted in death. Conclusions Spontaneous renal rupture associated with upper urinary tract calculi is a relatively rare occurrence and is frequently accompanied by severe urinary tract infections. Treatment strategies should be tailored to the individual patient’s clinical status.更多还原