外引流方式在输尿管结石合并尿脓毒血症治疗中的应用效果  

Application Effect of External Drainage Method in Treatment of Ureteral Calculus Combined with Urosepsis

作　　者：包华宇 Bao Huayu(Department of Urology Surgery,The First People's Hospital of Qinzhou,Qinzhou 535000,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]钦州市第一人民医院泌尿外科,广西壮族自治区钦州535000

出　　处：《中国社区医师》2024年第10期59-61,共3页Chinese Community Doctors

基　　金：广西钦州市科研项目(编号:20202718)。

摘　　要：目的:分析外引流方式在输尿管结石合并尿脓毒血症治疗中的应用效果。方法:选取2020年10月—2022年5月钦州市第一人民医院收治的输尿管结石合并尿脓毒血症患者64例作为研究对象,随机分为两组,各32例。对照组行输尿管镜双J管置入术,观察组行超声引导下经皮肾穿刺造瘘术。比较两组治疗效果。结果:观察组尿毒症控制时间、住院时间短于对照组,差异有统计学意义(P<0.05);两组引流成功率比较,差异无统计学意义(P>0.05)。术前,两组降钙素原(PCT)、C反应蛋白(CRP)、嗜中性粒细胞(NEUR)、白细胞(WBC)水平比较,差异无统计学意义(P>0.05);术后2 d,两组PCT、CRP、NEUR、WBC水平低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P=0.021)。结论:对于输尿管结石合并尿脓毒血症患者,内、外引流方式的引流成功率均较高,但外引流方式能够更好地控制感染情况,减少并发症,促进患者恢复。Objective:To analyze the application effect of external drainage method in treatment of ureteral calculus combined with urosepsis.Methods:A total of 64 patients with ureteral calculus and urosepsis admitted to the First People's Hospital of Qinzhou from October 2020 to May 2022 were selected as the study subjects.They were randomly divided into two groups with 32 cases in each group.The control group received ureteroscopyic double J tube implantation,while the observation group received percutaneous nephrostomy with ultrasound guidance.The treatment effects of the two groups were compared.Results:The control time for uremia and length of hospital stay in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the success rate of drainage between the two groups(P>0.05).Before operation,there was no significant difference in the levels of procalcitonin(PCT),C-reactive protein(CRP),neutrophils(NEUR)and white blood cells(WBC)between the two groups(P>0.05).On postoperative 2 d,the levels of PCT,CRP,NEUR and WBC in the two groups were lower than those before operation,the levels in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.021).Conclusion:In patients with ureteral calculus and urosepsis,both internal and external drainage methods have a higher success rate of drainage.However,external drainage method can better control infections,reduce complications,and promote the recovery of patients.

关 键 词：经皮肾穿刺造瘘术 引流 输尿管结石 尿脓毒血症 

分 类 号：R693.4[医药卫生—泌尿科学] R459.7[医药卫生—外科学]