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目的:探讨盆腔肿瘤致急性梗阻性肾功能损害的治疗方法。方法:对12例盆腔肿瘤致梗阻性重度肾功能损害的病人,先行血液透析治疗,待病情稳定后首选膀胱镜检查,并逆行插输尿管导管,或行经皮肾穿刺造瘘或输尿管造瘘术。结果:12例病人经上述处理后即进入多尿期,5d内8例肾功能完全恢复,1周内10例肾功能恢复正常,1例明显好转(肾功能代偿期),1例并发多脏器功能衰竭死亡。少尿或无尿时间长短与肾功能恢复有密切关系。结论:恶性盆腔肿瘤并发梗阻性肾功能衰竭若及时解除梗阻可取得显著疗效,不仅能减轻病痛,还能大大延长存活期。输尿管支架管置入术、经皮肾穿刺造瘘和输尿管造瘘术是解除梗阻的理想手术方式。
Objective: To investigate the treatment of acute obstructive renal dysfunction caused by pelvic tumor. Methods: 12 cases of pelvic tumors caused by obstructive severe renal impairment patients, the first hemodialysis treatment, stable disease after the first choice of cystoscopy and retrograde catheterization of the ureter, or percutaneous nephrostomy or ureterostomy. Results: Twelve patients entered the polyuria stage after the above-mentioned treatment. In the 5th day, the renal function of 8 cases recovered completely. Ten cases of renal function returned to normal within one week, one case improved obviously (renal decompensation stage) and one case complicated with more Organ failure and death. Oliguria or anuria length of time and renal function recovery are closely related. Conclusion: Malignant pelvic tumors with obstructive renal failure can be significantly relieved if the obstruction is relieved in time, not only can reduce the pain but also prolong the survival time greatly. Ureteral stent implantation, percutaneous nephrostomy and ureterostomy is the ideal surgical method to relieve obstruction.