臨床泌尿器科61巻13号

2007年12月発行

特集 泌尿器科救急

尿路結石・上部尿路閉塞

著者： 金山博臣¹ 高橋正幸¹

所属機関： ¹徳島大学ヘルスバイオサイエンス研究部泌尿器科

ページ範囲：P.1095 - P.1100

文献概要

要旨　尿路結石症の疝痛発作により救急外来を受診する患者は多く，救急外来では，まず尿路結石症とイレウス，消化管穿孔，腸間膜動脈血栓症などの消化器疾患，解離性大動脈瘤などの生命を脅かす可能性があり緊急の処置を要する疾患との鑑別が最も重要である。また，尿路結石症と診断した場合，感染を伴っていなければ疼痛管理が中心となるが，上部尿路閉塞に腎盂腎炎を伴っている場合，全身状態の悪化から敗血症性ショックを起こす可能性がある。患者年齢，感染症の重症度，全身状態を十分に把握し，致命的になる前に適切に経皮的腎瘻造設術や，尿管ステント留置術などのドレナージ術を含めた集学的治療を行わなければならない。

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