目前,输尿管软镜碎石需使用输尿管软镜导引鞘引流液体,以降低肾盂内压力,提高手术视野的清晰度,从而降低感染、肾脏出血及热损伤的发生率,但临床工作中我们会遇到部分患者输尿管软镜导引鞘无法到达合适位置,出现手术时无液体引流的情况.本文旨在探讨我院无引流状态输尿管软镜碎石术患者16例的减压体会.

目的对闭合性肾损伤的临床诊疗方法进行探讨,以提高其诊疗水平。方法对本院2009年1月至2012年3月期间收治的59例闭合性肾损伤患者临床诊疗资料进行回顾性分析。结果本组患者共59例,治愈56例,死亡3例。非手术治疗者47例,其中有2例因多脏器损伤失血过多难以纠正而死于器官衰竭。其余患者血尿均在5～30天全部消失,其他临床症状也同时好转痊愈。手术治疗者共12例,其中1例因合并重症脑挫裂伤而死亡,其余患者均痊愈出院。选择性肾动脉栓塞术1例。结论闭合性肾损伤是在诊断明确后尽快制定治疗方案,保守治疗无效后考虑手术治疗。

Objective:To study the diagnosis value of serum ornithine carbamyl transferase in patients with acute kidney contusion.Methods: Thirty-four patients with acute kidney contusion in our hospital from May 2009 to June 2012 were selected as observation group,and 34 healthy personnel at the same time were selected as control group,then the serum OCT,CysC,Scr,hs-CRP,Ccr and renal aorta hemodynamics indexes of two groups were compared.Results: The serum OCT,CysC,Scr and hs-CRP of observation group were all higher than those of control group,Ccr was lower than that of control group,renal aorta Vmax and Vmin were lower than those of control group,AT,RI and PI were higher than those of control group,and the change range in patients with severe contusion were bigger than those of mild patients,the change range in patients with open wounds were bigger than those of closed wounds(P<0.05).Conclusion: The diagnosis value of serum ornithine carbamyl transferase in patients with acute kidney contusion is higher,and it is consistent with the change of renal damage related indexes and inflammatory factor of patients.