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[61例输尿管梗阻所致肾后性急性肾衰竭患者的临床研究]

[Clinical studies on 61 patients with post-renal acute renal failure caused by ureteral obstruction].

作者信息

Higa I, Imagawa A

机构信息

Department of Urology, Takamatsu Red Cross Hospital.

出版信息

Hinyokika Kiyo. 1987 Jul;33(7):1005-10.

PMID:3687622
Abstract

The clinical course of 61 patients with post-renal acute renal failure caused by ureteral obstruction seen between January, 1976 and December, 1985, was studied retrospectively. Twenty of the patients were men between 55 and 85 years old, and 41 were women between 35 and 82 years old. In 50 of the 61 patients, uremia was caused by ureteral obstruction secondary to malignant tumors, and in 11, it was secondary to benign diseases. We divided the patients into two groups, those with primary malignant tumors and those with benign diseases. The location of the primary tumors in the malignant group was the genital system in 28 patients, upper gastrointestinal tract in 7, colorectum in 12, the urinary system in 2, and one was unclear. The benign group included 4 with urolithiasis, 3 with pelviureteral junction stenosis, 3 with post-operative ureteral stricture, and 1 with bilateral ureteral ligation due to operation error. Urinary diversion or reconstruction was performed on 56 of the 61 patients; bilateral nephrostomy in 6, unilateral nephrostomy in 16, bilateral ureterocutaneostomy in 8, unilateral ureterocutaneostomy in 11, unilateral nephrostomy with contralateral ureterocutaneostomy in 2, ureterolithotomy in 2, pyeloplasty in 2, ureterovesiconeostomy in 1, and insertion of a ureteral stent in 8. Of the remaining 4 patients 3 were treated by hemodialysis, and the other patient refused treatment. There was no significant difference in recovery of renal function between those patients undergoing only unilateral diversion and those undergoing bilateral diversion.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对1976年1月至1985年12月间收治的61例输尿管梗阻所致肾后性急性肾衰竭患者的临床病程进行回顾性研究。其中20例为男性,年龄在55至85岁之间;41例为女性,年龄在35至82岁之间。61例患者中,50例尿毒症由恶性肿瘤继发输尿管梗阻引起,11例由良性疾病继发。我们将患者分为两组,原发性恶性肿瘤组和良性疾病组。恶性组中原发肿瘤部位:28例位于生殖系统,7例位于上消化道,12例位于结直肠,2例位于泌尿系统,1例不明。良性组包括4例尿路结石、3例肾盂输尿管连接处狭窄、3例术后输尿管狭窄、1例因手术失误双侧输尿管结扎。61例患者中56例行尿流改道或重建手术:6例行双侧肾造瘘术,16例行单侧肾造瘘术,8例行双侧输尿管皮肤造口术,11例行单侧输尿管皮肤造口术,2例行单侧肾造瘘术并对侧输尿管皮肤造口术,2例行输尿管取石术,2例行肾盂成形术,1例行输尿管膀胱吻合术,8例行输尿管支架置入术。其余4例患者中,3例接受血液透析治疗,另1例拒绝治疗。仅接受单侧改道和接受双侧改道的患者肾功能恢复情况无显著差异。(摘要截选至250词)

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