急性输尿管结石梗阻合并严重感染的微创治疗效果观察  

Observation on the Effect of Minimally Invasive Treatment of Acute Ureteral Calculi with Severe Infection

作　　者：文航 曾志宇 朱黎 刘付国琛 WEN Hang ZENG Zhiyu ZHU Li LIU FU Guochen(Department of Urology, Zhuhai Traditional Chinese Medicine and Western Medicine Hospital, Zhuhai 519020 China)

机构地区：[1]珠海市中西医结合医院泌尿外科,广东珠海519020

出　　处：《锦州医科大学学报》2017年第5期39-41,共3页Journal of Jinzhou Medical University

基　　金：广东省珠海市科技计划项目;项目编号:2017J038

摘　　要：目的观察微创治疗在急性输尿管结石梗阻合并严重感染患者中的临床疗效。方法选取我院67例急性输尿管结石梗阻合并严重感染患者,均予以碎石前有效抗感染、引流解除梗阻,后期据情况选择合适取石碎石术,观察临床效果。结果膀胱镜下逆行插管引流成功者21例,一次性成功率为100%,尿血并发率14.29%;而超声引导下经皮肾细针穿刺置管引流成功者46例,一次性成功率100%,尿血并发率2.17%,两种引流方法其差异比较无统计学意义(P>0.05)。19例患者ESWL术后1例患者明显出血;9例患者PCNL术后1例出血,而39例患者成功完成URL且无出血情况发生。术后随访均无重大临床并发症发生,且术后1 w内血象、临床症状及体征均恢复正常。术后4 w安排B超复查提示结石排尽,其肾功能恢复正常。结论微创治疗在急性输尿管结石梗阻合并严重感染患者的运用效果显著,能够有效降低患者术后相关并发症,且创伤小,恢复快。值得临床广泛运用。Objective To observe the clinical effect of minimally invasive treatment for patients suffering from severe ureteral calculi with severe infection. Methods 67 cases of acute ureteral calculi obstruction with severe infection in our hospital were given effective anti-infection and drainage to relieve obstruction before the lithoclasty. Based on the actual situation,the appropriate lithectomy was selected and the clinical effect was observed. Results Endoscopic retrograde catheterization was successfully performed in 21 patients,and the one-time success rate was 100%. The incidence of hematuria was 14. 29%.（ P0. 05）. Ultrasound-guided percutaneous renal fine needle drainange was successful in 46 cases,and the one-time success rate was 100%. The incidence of hematuria was 2. 17%. There was no statistically significant difference between the two drainage methods（ P 0. 05）. After ESWL,1 patient had obvious bleeding among the 19 patients,9 patients had bleeding after PCNL surgery,and 39 patients completed the URL successfully without bleeding. There were no significant complications after the operation,and hemogram,clinical symptoms and signs returned to normal status within one week after operation. B-mode ultrasonic examination was arranged four weeks after operation,which showed that alculi was removed thoroughly. The renal function was recovered. Conclusion Minimally invasive treatment is effective for patients suffering from acute ureteral calculi with severe infection. It can effectively reduce the postoperative complications and has minimal invasion and rapid recovery,which is worth using widely clinically.

关 键 词：急性输尿管结石 梗阻 严重感染 微创治疗 临床疗效 

分 类 号：R693.4[医药卫生—泌尿科学]