早期逆行置入双J管引流术和经皮肾穿刺造瘘引流术急诊处理输尿管结石梗阻合并尿脓毒血症的效果  

The Effect of Early Retrograde Double J Tube Drainage and Percutaneous Nephrostomy Drainage for Emergency Treatment of Ureteral Calculi Obstruction with Uroseptemia

作　　者：郝建 HAO Jian(Department of Urology,Xintai People's Hospital,Xintai,Shandong Province,271200 China)

机构地区：[1]新泰市人民医院泌尿外科,山东新泰271200

出　　处：《世界复合医学》2021年第6期118-121,共4页World Journal of Complex Medicine

摘　　要：目的探索早期逆行置入双J管引流术和经皮肾穿刺造瘘引流术急诊处理输尿管结石梗阻合并尿脓毒血症的效果。方法2015年1月—2019年1月纳入的80例输尿管结石梗阻合并尿脓毒血症患者,随机分对照组40例和观察组40例。对照组经皮肾穿刺造瘘引流术急诊处理,观察组早期逆行置入双J管引流术急诊处理。比较两组患者引流成功率、尿脓毒血症好转的平均时间、手术时间、并发症发生率、手术前后患者外周血白细胞计数水平、最高体温、最高心率、肾积水程度。结果观察组引流成功率是100.00%,无出现失败的情况。而对照组有8例失败,有32例引流成功,引流成功率是80.00%。观察组引流成功率高于对照组,差异有统计学意义(χ^(2)=6.806,P=0.009<0.05)。观察组手术时间、尿脓毒血症好转的平均时间(67.02±7.14)min、(5.12±0.01)d短于对照组(85.21±10.67)min、(6.21±2.01)d,差异有统计学意义(t=8.961、3.430,P<0.05)。两组并发症发生率观察组2例(5.00%),对照组3例(7.50%),差异无统计学意义(χ^(2)=0.000,P>0.05)。两组均无出险周围脏器损伤,无输尿管穿孔和损伤,无死亡病例。治疗后两组外周血白细胞计数水平、最高体温、最高心率、肾积水程度均显著低于治疗前,差异有统计学意义(P<0.05)。结论输尿管结石梗阻合并尿脓毒血症患者实施早期逆行置入双J管引流术急诊处理和经皮肾穿刺造瘘引流术急诊处理均效果确切。Objective To explore the effect of early retrograde double J tube drainage and percutaneous nephrostomy drainage for emergency treatment of ureteral stone obstruction with urosepsis.Methods From January 2015 to January 2019,80 patients with ureteral calculi obstruction combined with uroseptemia were randomly divided into a control group of 40 cases and an observation group of 40 cases.The control group was treated with percutaneous nephrostomy and drainage for emergency treatment,and the observation group was treated with early retrograde double J tube drainage.The success rate of drainage,average time to improve urosepsisemia,operation time,complication rate,peripheral blood white blood cell count,maximum body temperature,maximum heart rate,degree of hydronephrosis were compared between the two groups of patients.Results The success rate of drainage in the observation group was 100.00%,and there was no failure.In the control group,8 cases failed and 32 cases succeeded in drainage.The drainage success rate was 80.00%.The success rate of drainage in the observation group was higher than that in the control group,the difference was statistically significant(χ^(2)=6.806,P=0.009<0.05).The average time for operation and improvement of urosepsis in the observation group time(67.02±7.14)min,(5.12±0.01)d were shorter than those of the control group(85.21±10.67)min,(6.21±2.01)d,the difference was statistically significant(t=8.961,3.430,P<0.05),respectively.The incidence of complications between the two groups,the observation group 2 cases(5.00%),the control group 3 cases(7.50%)(χ^(2)=0.000,P>0.05).There was no injury to the surrounding organs,no perforation or injury of the ureter,and no deaths in the two groups.After treatment,the levels of white blood cell count,maximum body temperature,high heart rate,and hydronephrosis in the two groups were significantly lower than those before treatment,the difference was statistically significant(P<0.05).Conclusion Patients with ureteral calculi obstruction and uroseptemia un

关 键 词：早期逆行置入双J管引流术 经皮肾穿刺造瘘引流术 急诊处理 输尿管结石梗阻合并尿脓毒血症 效果 

分 类 号：R69[医药卫生—泌尿科学]