术前综合评价对输尿管结石梗阻急性肾衰竭患者治疗方案选择的临床价值

目的 探讨术前综合评价对输尿管结石梗阻急性肾衰竭患者治疗方案选择的临床价值.方法 收集确诊为输尿管结石梗阻急性肾衰竭患者86例,依据患者生化指标、输尿管梗阻和肾积水梗阻情况,分为安全组(11~15分),风险组(7~10分)和危险组(<7分).安全组患者予立即行手术治疗;风险组患者根据患者情况予血液透析后行手术治疗或予急诊手术治疗;危险组患者予血液透析后行手术治疗.手术后随访1月,患者肾功能恢复情况及输尿管梗阻和肾积水改善情况.结果 安全组患者肾功能完全恢复,输尿管梗阻和肾积水情况完全缓解;风险组患者肾功能完全恢复,分别有1例患者存在输尿管梗阻及肾积水;危险组患者有4例患者肾功能存在轻度损害,分别有2例患者存在输尿管梗阻及肾积水.结论 术前综合评价对输尿管结石梗阻急性肾衰竭患者治疗方案的选择具有重要的临床价值.

Clinical value of pre-operative general evaluation on therapeutic protocol selection in patients with acute renal failure induced by ureteral calculus obstruction

Objective To understand the clinical value of pre-operative general evaluation on therapeutic protocol selection in patients with acute renal failure induced by ureteral calculus obstruction.Methods 86 patients defined as acute renal failure induced by ureteral calculus obstruction were assigned into safe group(11-15 points),risk group(7-10 points) and dangerous group(<7points) according to the biochemistry indexes,conditions of ureteral obstruction and hydronephrosis.Patients in safe group and dangerous group respectively underwent urgent surgery and post-hemodialysis surgery.Patients in risk group underwent either urgent surgery or post-hemodialysis surgery,according to patients’ situation.Following up for 1 month after surgery,to evaluate the situation of renal function recovery,ureteral obstruction and hydronephrosis in patients.Results In safe group,renal function were completely recovery,while reteral obstruction and hydronephrosis were completely relieved.In risk group,renal function were completely recovery,while there were one patient with ureteral obstruction and one patient with hydronephrosis.There were four patients with mild renal impairment in dangerous group.Two patients of them were with ureteral obstruction,and the other two of them were with hydronephrosis.Conclusion Pre-operative general evaluation was of great value on the selection of therapeutic protocol in patients with acute renal failure inducded by ureteral calculus obstruction.