输尿管支架相关尿路感染患者肾脏形态与红细胞形态变化研究  

Changes of renal morphology and erythrocyte morphology of patients with ureteral stent-related urinary tract infections

作　　者：牛俊豪[1] 王俊勇[1] 张莹[2] 张君[1] 王朝阳[1] 

机构地区：[1]郑州大学附属郑州中心医院泌尿外科二病区,河南郑州450005 [2]郑州大学附属郑州中心医院急诊重症监护室,河南郑州450005

出　　处：《中华医院感染学杂志》2017年第14期3271-3273,3295,共4页Chinese Journal of Nosocomiology

摘　　要：目的观察总结输尿管支架相关尿路感染患者肾脏形态与红细胞形态的变化特点,为临床准确评价输尿管支架相关尿路感染病情提供可靠信息。方法选取医院泌尿外科2013年2月-2015年12月期间输尿管支架留置术后并发尿路感染的患者61例作为感染组,同时选取同期接受输尿管支架留置后无感染的63名患者作为未感染组,在泌尿外科手术前后分别进行肾静态显像检查和尿红细胞形态分析,对比分析两组患者手术前后肾脏形态、尿红细胞形态的变化特点。结果手术前两组尿红细胞形态均以均一型为主,且未见肾脏炎性病变,组间尿红细胞形态异常率、肾炎病变率无显著性差异;手术后,感染组红细胞形态异常率(80.3%)、肾脏阳性改变率(57.4%)显著高于对照组,组间数据比较,有显著性差异(P<0.05)。结论输尿管支架相关尿路感染患者多存在尿红细胞形态异常、尿白细胞增多、肾实质炎性病变等病理性改变,输尿管支架管并发尿路感染患者应积极进行尿红细胞分析和肾静态显像检查,尽早准确评估肾实质受累情况。OBJECTIVE To observe the changes of renal morphology and erythrocyte morphology of patients with ureteral stent-related urinary tract infections so as to provide reliable information for accurate clinical evaluation of the ureteral stent-related urinary tract infections.METHODS Totally 61 patients who were treated with ureteral stent indwelling in urology department from Feb 2013 to Dec 2015 and were complicated with postoperative urinary tract infections were chosen as the infection group,meanwhile,63 patients who were not complicated with infection after the ureteral stent indwelling were set as the non-infection group.The renal static imaging examination and morphological analysis of urine erythrocyte were respectively carried out before and after urological surgeries,and the characteristics of renal morphology and urine erythrocyte morphology were observed and compared between the two groups of patients before and after the surgeries.RESULTS The homogeneous urine erythrocyte morphology was dominant among the two groups of patients before the surgeries,renal inflammatory lesions were not found,and there was no significant between-group difference in the abnormal rate of urine erythrocyte morphology or rate of nephritis lesions.The abnormal rate of erythrocyte morphology（80.3%）and rate of positive change of kidney（57.4%）of the infection group were significantly higher than those of the control group（P〈0.05）.CONCLUSIONThere are some pathological changes such as abnormal urine erythrocyte morphology,urinary leukocytosis,and renal parenchymal inflammatory lesions in the patients with ureteral stent-related urinary tract infections.It is necessary to actively perform the urine erythrocyte analysis and renal static imaging examination for the patients with ureteral stent-related urinary tract infections and accurately assess the renal parenchymal involvements as early as possible.

关 键 词：输尿管支架 尿路感染 肾脏形态 红细胞形态 

分 类 号：R691.3[医药卫生—泌尿科学]