输尿管镜下一期双J管留置联合二期输尿管结石清除术治疗输尿管结石致肾积脓40例  

Effect of one-stage double-J catheter indwelling combined with second-stage removal of ureteral calculi under ureteroscope in treatment of pyonephrosis due to ureteral calculi:a report of 40 cases

作　　者：方少洪 王勤军 廖国强 FANG Shao-hong;WANG Qin-jun;LIAO Guo-qiang(Department of Urology,the Second People's Hospital of Longgang District of Shenzhen,Shenzhen 518112,Guangdong,CHINA;Department of Urology,Shenzhen Longhua District Central Hospital,Shenzhen 518000,Guangdong,CHINA)

机构地区：[1]深圳市龙岗区第二人民医院泌尿外科,广东深圳518112 [2]深圳市龙华区中心医院泌尿外科,广东深圳518000

出　　处：《海南医学》2020年第11期1442-1444,共3页Hainan Medical Journal

摘　　要：目的观察输尿管镜下一期双J管留置联合二期输尿管结石清除术治疗输尿管结石致肾积脓的临床效果。方法选取2015-2019年在深圳市龙岗区第二人民医院泌尿外科诊治的40例输尿管结石致肾积脓患者进行研究。所有患者均采取输尿管镜下一期双J管留置联合二期输尿管结石清除术治疗,术后根据尿培养结果给予抗生素治疗3 d。二期输尿管结石清除术后,观察患者的治疗效果、结石清除情况和并发症发生率。结果置管后,大量脓絮状浑浊尿液顺利导出,置管时间为(19.87±3.11) min;二期手术时机为置管后72 h无发热;置管24 h内,40例患者的腰部疼痛症状得到有效改善;置管24~48 h内,大部分患者的体温均在1 d内恢复正常,且只有2例患者出现高热症状,体温>38.5℃,但给予两联抗生素治疗后,患者的体温在2 d内恢复正常;40例患者的结石分别分布在输尿管中上段及输尿管下段,治疗后,经泌尿系统腹部平片检查显示:完全清除37例,部分清除2例,未完全清除1例,清除率为97.50%;治疗后,所有患者均未出现败血症、大出血、穿孔及撕脱等并发症。结论输尿管镜下一期双J管留置联合二期输尿管结石清除术治疗输尿管结石致肾积脓能有效清除患者体内结石,且手术安全性较高,临床治疗效果显著。Objective To observe the clinical effect of one-stage double-J catheter indwelling combined with second-stage removal of ureteral calculi under ureteroscope in the treatment of pyonephrosis due to ureteral calculi.Methods A total of 40 patients with pyonephrosis due to ureteral calculi, who admitted to Department of Urology, the Second People’s Hospital of Longgang District of Shenzhen from 2015 to 2019, were selected as the research subjects.All the patients were treated by one-stage double-J catheter indwelling combined with second-stage removal of ureteral calculi under ureteroscope. Antibiotics were given to the patients for 3 days according to the results of urine culture. After the second-stage ureteral stone removal, the therapeutic effect, calculus clearance and complication rate of the patients were observed. Results After catheterization, a large amount of pus flocculent turbid urine was successfully exported, and the catheterization time was(19.87±3.11) min;the second operation time was 72 hours after catheterization without fever. Within 24 hours after the catheterization, the symptoms of lumbar pain in 40 patients were effectively improved;within 24 to 48 hours after the catheterization, the body temperature of most patients returned to normal within 1 day, and only 2 patients had high fever symptoms(the body temperature was more than 38.5℃, but after the treatment with two antibiotics, the patients temperature returned to normal within 2 days);the stones of 40 patients were distributed in the upper and lower ureters;after treatment, abdominal plain film examination of urinary system showed: 37 cases were completely cleared, 2 cases were partially cleared, 1 case was not completely cleared, the clearance rate was97.50%;after treatment, no complications such as septicemia, bleeding, perforation and avulsion occurred in all patients.Conclusion One-stage double-J catheter indwelling combined with second-stage removal of ureteral calculi under ureteroscope can effectively remove patients’ stones i

关 键 词：输尿管结石 肾积脓 输尿管镜 双J管 疗效 并发症 

分 类 号：R693.4[医药卫生—泌尿科学]