Aretrospective Clinical Analysis Of Threeemergency Surgical Procedures For The Acute Obstructive Kidney Injury Caused By Ureteral Calculi

Objective:To evaluate the efficacy and safety of ureter retrograde intubation drainage,percutaneous nephrolithotomy and ureteroscopic lithotripsy for emergency treatment of acute obstructive kidney injury caused by ureteralcalculi.Methods: Retrospectively analyzed the clinical data of 101 patients with acuteobstructive kidney injury caused byureteral calculi who were hospitalized in urology from the First Affiliated Hospital of Guangxi Medical University from January 2012 to December 2016.101 patients were hospitalized within 24 hours of surgical treatment,including ureteral retrograde catheterization in 60 cases,percutaneous nephrostomy in 20 cases,ureteroscopic lithotomy in 21 cases.Counted of success rate of surgery,operation time,operative blood loss,postoperativecomplications,hospitalization time,preoperative and postoperative blood urea nitrogen,creatinine,and then analyze the data for evaluation and comparison.Results:The group of 101 patients with mild hydronephrosis in 81 cases.Compared with the general operation of the ureteral catheterization group and the PCN group,the URSL group with shorter duration of pathology,lower of intravascular leukocyte,erythrocyte WBC and NEU%.The difference was statistically significant.There was no significant difference in the general situation of preoperative transfusion group and PCNL group.The success rate of surgery in the ureteral catheterization group,PCN group and URSL group was 75.81%,100%and 100%.The success rate of PCN was higher than that of ureter retrograde intubation and the difference was statistically significant(P <0.05).20 cases of moderate-severe hydronephrosis,general situation between ureter retrograde catheterization group and PCN group before surgery was no difference,the success rate of relieve obstruction was52.38%,100% respectively.The success rate of PCN was higher than that of ureter retrograde intubation and the difference was statistically significant(p <0.05).There was no significant difference in the operation time between the three groups,However,the number of surgical bleeding,hospitalization,PCN group was greater than the ureter retrogradeintubation group,URSL group,and the difference was statistically significant(P<0.01).In the complication,the occurred rate of ureter retrograde intubation group was 5.00%(3/60),Of which severe complications accounted for1.67%(1/60).The occurred rate of PCN group was 24.00%(6/25),Of which severe complications accounted for 8.00%(2/25).The occurred rate of URSL group was 14.29%(3/21)and no serious complications.The complication occurred rate was significantly higher in the PCN group than in the ureteral retrograde intubation group(P < 0.05),while the URSL group and the PCN group were no significant difference.87 patients had been relieved obstruction by surgery,and other patients receive hemodialysis who received gravel surgery after2-5days.After the removal of obstruction,renal function quickly recovered.There was no significant difference in renal function recovery(BUN,SCr)among the ureter retrograde intubation group,the PCN group,the URSL group and the hemodialysis group(P >0.05).Conclusion:1.Ureter retrograde catheter drainage,PCN,URSL are safe and effective emergency surgical procedures in treating acuteobstructive kidney injury caused by ureteral calculi.2.Treatment of AKI caused by ureteral calculi with urinary tract infection,the preferred method is ureter retrograde intubation,followed by PCN.3.URSL intreating AKI caused by ureteral calculi without urinary tract infectionand serious complications was featured high stone removal rate,eliminating the second phase of gravel,less seriouscomplications.