Bergman S M, Frentz G D, Wallin J D
Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana 70112.
J Urol. 1990 Jan;143(1):113-5. doi: 10.1016/s0022-5347(17)39884-1.
The nonsurgical approach to unilateral ureteral obstruction due to impaction of a blood clot is described. A patient with the nephrotic syndrome secondary to minimal change disease had gross hematuria and acute renal failure following percutaneous renal biopsy. After he responded to prednisone therapy, clot obstruction developed at the site of the percutaneous biopsied kidney, which was treated with intracaliceal infusion of streptokinase via a ureteral catheter. Complete resolution of the clot and the urinary tract obstruction was accomplished within 3 days. This approach appears to be the treatment of choice in upper urinary tract obstruction secondary to blood clots when simple ureteral catheter drainage is ineffective.
本文描述了因血凝块嵌顿导致单侧输尿管梗阻的非手术治疗方法。一名患有微小病变肾病继发肾病综合征的患者，在经皮肾活检后出现肉眼血尿和急性肾衰竭。在他对泼尼松治疗有反应后，血凝块梗阻在经皮活检的肾脏部位出现，通过输尿管导管向肾盂内注入链激酶进行治疗。血凝块和尿路梗阻在3天内完全消退。当单纯输尿管导管引流无效时，这种方法似乎是血凝块继发上尿路梗阻的首选治疗方法。
