尿路梗阻后自發(fā)性腎周尿外滲23例分析

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Analysis of 23 cases of spontaneous perirenal urine extravasation after urinary tract obstruction

MA Peili，DAI Haitao，ZHANG Zhong，LIU Yuanhua，GUO Peichao，HU Zhenxing，PENG Changwei

（Department of Urology，The First Affiliated Hospital of Yangtze University，Jingzhou 434000，China）ABSTRACT：ObjectiveTo investigate the clinical manifestations and explore the experience of diagnosis and treatment of spontaneous perirenal urine extravasation after urinary tract obstruction so as to improve the understanding of the disease.MethodsThe clinical data of 23 patients with spontaneous perirenal urine extravasation after obstruction treated at our hospital during 2018 and 2020 were retrospectively analyzed，including the primary diseases，clinical manifestations，imaging examination，treatment and prognosis. The key points of diagnosis and treatment were summarized.ResultsOf the 23 patients，there were 15 males and 8 females，with an average age of 43.4 years. These cases were diagnosed by imaging tests such as ultrasound，computed tomography urography （CTU） and  CT. Ureteroscopic lithotripsy was performed in 3 patients with ureteral calculi，retrograde ureteral catheterization in 4 patients and percutaneous nephrostomy in 13 patients. Afterwards，a second phase surgery was performed based on the patients condition. Of the 3 patients with tumor metastasis who underwent retrograde ureteral catheterization，2 operation were successful，and 1 operation failed and then converted to nephrostomy and drainage under B-ultrasound localization.ConclusionCTU should be performed as soon as possible to make a definite diagnosis. Treatment can be achieved with ureteral retrograde catheterization or percutaneous nephrostomy to achieve local decompression，followed by secondary surgery to treat the primary cause of obstruction.

KEY WORDS：urinary tract obstruction；spontaneous urinary extravasation；computed tomography urography；upper urinary stones；percutaneous nephrostomy摘要：目的探討尿路梗阻后自發(fā)性腎周尿外滲的臨床表現(xiàn)和診治經(jīng)驗(yàn)，提高對該疾病的認(rèn)識(shí)。（剩余7200字）