孤立肾输尿管结石急性梗阻伴感染的诊治策略

    Treatment of the acute obstruction of ureteral calculus complicated with infection in patient with solitary kidney

    • 摘要: 目的:探讨孤立肾输尿管结石急性梗阻伴感染的诊治策略,提高诊治水平。方法:回顾分析2例孤立肾输尿管结石急性梗阻伴感染患者的诊治过程,总结并结合文献进行分析。结果:2例孤立肾患者均急诊行输尿管镜钬激光碎石术;例1结石最大直径0.7 cm,感染严重,术后出现败血症、感染性休克、急性肾功能衰竭,入ICU抗感染、血液净化等对症治疗,后痊愈出院;例2结石最大直径0.5 cm,手术顺利,术后给予抗感染、补液等对症处理,恢复良好,痊愈出院。结论:孤立肾输尿管结石急性梗阻伴感染病情进展快,肾功能损害重,应采用个体化治疗,尽早解除梗阻,最大限度保护肾功能。

       

      Abstract: Objective: To explore the diagnosis and treatment strategy of the acute obstruction of ureteral calculus complicated with infection in patients with solitary kidney for improving the diagnosis and treatment level.Methods: The treatment processes of the acute obstruction of ureteral calculus complicated with infection in two patients with solitary kidney were retrospectively analyzed,and the relevant literatures were reviewed.Results: Two patients with solitary kidney were treated with Holmium laser lithotripsy in emergency.One case with 0.7 cm calculus,postoperative sepsis,infectious shock and acute renal failure was treated with anti-infection and blood purification,and the patient cured.One case with 0.5 cm calculus and successful operation was treated with anti-infection and rehydration,and the patient recovered.Conclusions: The progression of ureteral calculus complicated with infection in patient with solitary kidney is fast and severe renal impairment.The individualized treatment should be used,the ureteral obstruction should be early relieved,and the renal function should be maximum protected.

       

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