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目的 探讨小儿上尿路结石梗阻造成急性肾衰的病理生理.分析手术治疗的临床疗效.方法 先行利尿合剂冲击疗法或经皮肾穿刺置管引流,改善垂危状况后手术取石解除梗阻.结果 对74例患儿的62个肾、19根输尿管、3个膀胱切开取石.67例获痊愈、7例死亡.结论 应用于成人的手术方法 也同样适用于小儿.手术解除一侧梗阻即可逆转全身情况,对侧择期手术肾功能并未发现代偿性减退或丧失.“,”Objective To review the efficacy of operative treatment for acute renal failure resulted from obstruction of upper urinary lithiasis.Methods Seventy-four cases(male 51,female 23)of acute renal failure caused by upper urinary lithiasis were admitted from 1985 to 1997.The age ranged from 4 months to 11 years(mean 2 yrs and 10 mons).Prompt drainge by insertion of percutaneous nephrostomy tube and ictus therapy with diuretic mixture were indicated until the clinical situation of renal failure improved.Results Among the 74 patients(kidney 62,ureter 19,bladder 3),who underwent surgical removal of the lithiasis,67 survived and 7 died.Conclusions The operative management of adults with urinary lithiasis is also fit for children.When patients with bilateral lesions,the general situation will be reversed by unilateral releasing from the obstruction.The function of the contralateral kidney after an selective operation is still kept well.