经皮肾穿刺造瘘与输尿管镜下逆行置入双J管治疗上尿路结石致尿源性脓毒血症患者的效果对比  

Comparison of the Effect of Percutaneous Nephrostomy and Retrograde Placement of Double J Tube under Ureteroscope in the Treatment of Patients with Urogenic Sepsis Caused by Upper Urinary Tract Stones

作　　者：汤天永 董志峰 TANG Tianyong;DONG Zhifeng(Department of Urology,The First People’s Hospital of Jingdezhen,Jingdezhen 333000,China)

机构地区：[1]江西省景德镇市第一人民医院泌尿外科,江西景德镇333000

出　　处：《中国伤残医学》2024年第23期42-45,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:对比经皮肾穿刺造瘘与输尿管镜下逆行置入双J管治疗上尿路结石致尿源性脓毒血症患者的效果。方法:选择2020年7月—2023年7月景德镇市第一人民医院收治的69例上尿路结石致尿源性脓毒血症患者为研究对象,将其随机分为内引流组(n=37)和外引流组(n=32)。内引流组采用输尿管镜下置入双J管治疗,外引流组采用经皮肾穿刺造瘘术治疗。比较两组手术相关指标、炎症反应、并发症发生情况。结果:两组术后引流成功率、手术时间比较,差异均无统计学意义(P>0.05);外引流组体温恢复及感染控制时间均短于内引流组,差异均有统计学意义(P<0.05)。术后1d,外引流组降钙素原、白细胞介素-6、C反应蛋白均低于内引流组,差异均有统计学意义(P<0.05)。两组并发症发生率分别为28.13%、10.81%,差异无统计学意义(P>0.05)。结论:对于上尿路结石致尿源性脓毒血症的患者,经皮肾穿刺造瘘术在体温恢复和感染控制时间上短于输尿管镜下逆行置入双J管,且炎症反应水平较低,但两者在术后引流成功率和并发症发生率上无显著差异。Objective:To compare the efficacy of percutaneous nephrostomy and retrograde placement of double J tube under ureteroscope in the treatment of patients with urogenic sepsis caused by upper urinary tract stones.Methods:A total of 69 patients with urogenic sepsis caused by upper urinary tract stones admitted to The First People’s Hospital of Jingdezhen from July 2020 to July 2023 were selected as the study objects,and were randomly divided into an internal drainage group(n=37)and an external drainage group(n=32).The internal drainage group was treated with double J tube implantation under ureteroscope,and the external drainage group was treated with percutaneous nephrostomy.Operation related indexes,inflammation response and occurrence of complications were compared between the two groups.Results:There were no significant differences in the success rate of postoperative drainage and operation time between the two groups(P>0.05).The time of body temperature recovery and infection control in the external drainage group was shorter than that in the internal drainage group,and the differences were statistically significant(P<0.05).On day 1 after surgery,procalcitonin,interleukin-6 and C-reactive protein in the external drainage group were lower than those in the internal drainage group,with statistical significance(P<0.05).The incidence of complications between the two groups was 28.13%and 10.81%,respectively,with no significant difference(P>0.05).Conclusion:For patients with urogenic sepsis caused by upper urinary tract stones,percutaneous nephrostomy is shorter in temperature recovery and infection control time than retrograde placement of double J tubes under ureteroscopy,and the level of inflammation is lower,but there is no significant difference in the success rate of postoperative drainage and complication rate.

关 键 词：尿源性脓毒血症 上尿路结石 经皮肾穿刺造瘘 输尿管镜 双J管 

分 类 号：R691.4[医药卫生—泌尿科学]