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独肾急性上尿路梗阻并感染性休克急性肾功能衰竭的外科治疗 被引量:3

Surgical treatment for single kidney acute upper urinary obstruction combined with septic shock and acute tenal failure
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摘要 目的探讨独肾急性上尿路梗阻并感染性休克的紧急处理措施。方法对20例独肾急性上尿路梗阻并感染性休克急性肾衰间竭患者,积极抗感染、纠正休克和电解质紊乱的同时,行急诊引流,其中11例行急症开放手术解除梗阻内置双"J"管引流,5例行双"J"管内引流,2例在B超引导下行细针穿刺置管,2例经皮穿刺置管引流。结果20例患者术后情况均得到有效改善,17例在术后3d内体温基本恢复正常,休克得到纠正,3例体温恢复正常后低血压持续存在5~7d。所有患者肾功能有不同程度恢复,但有3例需血液透析。其中1例因并发双肺感染多器官功能障碍死亡。结论对独肾急性上尿路梗阻并感染性休克的患者,处理应积极,在抗感染、纠正休克和水、电解质、酸碱平衡紊乱的同时,及时行急症引流尤为重要。 [Objective] To explore the diagnosis and treatment of single kidney acute upper urinary obstruction combined with septic shock and acute renal failure. [Methods] Twenty cases of single kidney ancte upper urinary obstruction combined with septic shock and acute rinal failure underwent urgent drainage, antibiotic therapy, correction, shock and electrolytic equilibrium, urgent open surgery and indwelling double-J slent in 5, indwelling stent by fine needle injection under the guidance of ultrasound B in 2, and percutaneous indwelling stent in 2. [Result] All of the 20 cases were improved after operation. Temperature was normal and shock correction was performed-3 days following operation among the 17 patients. Low blood pressure showed during 5-7 days after temperature normalization following operation among 3 patients. The renal function was improved in all the patients. Hemodialysis was needed in 3. 1 case died with MOSF because of pneumonia. [Conclusions] It is important to urgent drainage besides antibiotic therapy, correction of shock and electrolytic equilibrium for single kidney acute upper urinary obstrution combined with septic shock and acute renal failure.
出处 《中国现代医学杂志》 CAS CSCD 北大核心 2007年第15期1881-1883,共3页 China Journal of Modern Medicine
关键词 独肾 尿路梗阻 休克 感染 引流术 singlekidney urinary tract obstruction Shock infections acute renal failure drainage
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