【摘要】 目的 探讨尿毒症长期血液透析患者胆囊结石的治疗和预防手术并发症的措施。 方法 2例因胆绞痛症状不缓解，于次日实施手术，1例行胆囊切除术，1例行胆囊切除并胆总管取石引流术。其余5例随着胆绞痛症状缓解，继续用抗生素1周。在肾内科协助下，7例均增加了透析次数，其中2例手术患者在术后第1天血液透析1次，并采用无肝素透析。 结果 手术2例未出现术中和术后并发症;6例痊愈出院，1例75岁女性患者因中毒性休克死亡。 结论 尿毒症长期血液透析患者胆囊结石外科治疗的关键是预防和处理外科并发症，应当严格掌握手术适应证，合理使用抗生素，积极控制因尿毒症引起的机体代谢紊乱，增加血液透析次数。

    关键词 胆囊结石 尿毒症 血液透析

    Surgical treatment for biliary lithiasis in patients with end-stage renal disease treated with haemodialysis

    Bai Ling，Xu Lijuan，Yang Hongwei，et al.

    Department of Surgery，323th Hospital of PLA，Xi'an710054.

    【Abstract】 Objective To discuss surgical treatment for patients with chronic renal failure on hemodialysis and certain measures for preventing peri-operative problems and postoperative complications.Methods Seven pa-tients with biliary lithiasis，who had a history of chronic renal failure treated with hemodialysis were treated by conser-vative and operative methods respectively.One case was treated with cholecystectomy with laparotomy.The other one was treated with choledochotomy.Results There were no any peri-operative problems and postoperative complica-tions in two cases through operation.Only one case of old female patient resulted in death due to accidental septic shock.Six patients recovered.Conclusion Prophylaxis and treatment of surgical complications ......