输尿管逆行置管和经皮肾造瘘术在糖尿病患者急性感染性输尿管梗阻中的应用  

Retrograde ureteric stent placement versus percutaneous nephrostomy for acute infected ureteral obstruction in diabetic patients

作　　者：梁任 邓朝君 霍颖钊 余竞 Liang Ren;Deng Chaojun;Huo Yingzhao;Yu Jing(Department of Urology,LuodingPeople'sHospital,Guangdong 527200,China)

机构地区：[1]罗定市人民医院泌尿外科,广东527200

出　　处：《中华腔镜泌尿外科杂志（电子版）》2022年第6期523-527,共5页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的比较逆行输尿管置管(USP)和经皮肾造瘘术(PCN)在糖尿病患者急性感染性输尿管梗阻中作为初始引流手术的治疗效果。方法2018年1月至2021年6月,共118例急性感染性输尿管梗阻的糖尿病患者人组。回顾性收集患者病历数据,比较两组手术失败率、并发症发生情况、肌酐恢复最低值时间、ICU入住率、死亡率。结果两组共118例患者,通过倾向性得分匹配分析后两组各有30例纳人分析。结果显示,USP和PCN手术的失败率和引流效果相同。在手术时间、疼痛评分、肌酐最低值及达到最低值时间、白细胞恢复正常时间、体温恢复正常时间、ICU入住率方面,两组具有基本相同的结果。在并发症方面,PCN组并发症事件数和并发症病例数均比USP组高(P<0.05)。结论USP和PCN都可作为糖尿病患者急性感染性输尿管梗阻的初始引流手术,但USP具有更少的并发症优势。Objective To compare the outcomes of retrograde ureteric stent placement(USP)and percutaneous nephrostomy(PCN)as initial drainage methods in diabetic patients with acute infected ureteral obstruction secondary to calculi.MethodsFrom January 2018 to June 2021,118 diabetic patients with acute infected ureteral obstruction were included.Data were obtained retrospectively and the outcomes were measured by failure rates of intervention,complications,period for return to creatinine(Cr)nadir,admission to intensive care unit(ICU),and all-cause mortality during hospital admission.Results There were 118 patients included,and each group had 30 patients entered the final analysis after propensity score matching.Treatment failure rate and drainage effect were similar between USP and PCN group.Both groups showed equivalent outcomes in operation time,pain scores,Cr nadir,time to Cr nadir,time to normal white blood cells,time to normal temperature,and admissios to ICU.However,there were more complications and more patients with complications in PCN group(P<0.05).ConclusionBoth USP and PCN were accepted options as initial drainage operations for acute infected ureteral obstruction in diabetic patients,but USP would be superior with less complications.

关 键 词：转输尿管逆行置管 经皮肾造瘘术 结石 感染 糖尿病 

分 类 号：R587.2[医药卫生—内分泌] R693[医药卫生—内科学]