微创治疗高龄患者孤立肾上尿路结石所致急性肾功能不全疗效观察

摘要

Objective To explore the effectiveness of minimally invasive treatment of acute renal dysfunction due to solitary upper urinary tract calculi in a solitary kidney in elderly patients. Methods Nine elderly patients with acute renal dysfunction due to solitary upper urinary tract calculi in a solitary kidney were enrolled. Among them, four patients had stones at kidneys and underwent ultrasonic lithotripsy under percutaneous nephroscope , four patients had stones at the middle and lower urinary tract and underwent pneumatic lithotripsy through ureteroscope , and two patients had stones at the upper urinary tract and underwent micro - channel percutaneous lithotomy. Results The surgical duration ranged 20 ～ 70 min ( mean : 45 min ), with few intra - operative blood loss. The time of activities after surgery was 12 ～48 h ( mean : 30 h ). The time from surgery to discharge ranged 3 ～ 6 d ( mean : 4 d ). Stones were completely cleared in 7 patients , and two patients underwent a second surgery.No significant complications were noted. Conclusion Minimally invasive treatment can effectively manage acute renal dvsfunction due to solitary upper urinary tract calculi in a solitary kidney in elderly patients.%目的 探讨微创治疗高龄患者孤立肾上尿路结石所致急性肾功能不全的临床效果.方法 高龄孤立肾上尿路结石致急性肾功能不全患者9例,其中结石位于肾脏4例,采用经皮肾镜超声碎石术;输尿管中下段3例,采用输尿管镜气压弹道碎石术;输尿管上段2例,采用微通道经皮肾造瘘取石术.结果 手术时间20～70 min,平均45 min;术中出血量少,术后下床时间12～48 h,平均30 h;术后出院时间3～6 d,平均4 d,一次结石完全清除7例(78%),另2例二次手术清除残余结石.所有患者均未出现并发症.结论 高龄患者孤立肾上尿路结石所致急性肾功能不全的治疗中,应用微创方法安全、可行.