泌尿系结石术后感染性休克患者急救中支架引流术与经皮肾穿刺造瘘术的疗效比较  

Comparison of the Efficacy of Stent Drainage and Percutaneous Nephrostomy in the Emergency Treatment of Infectious Shock After Urinary Tract Stone Surgery

作　　者：徐洪磊 XU Honglei(Wucheng County People's Hospital Uroanal and Colorectal Surgery,Wucheng 253300,China)

机构地区：[1]武城县人民医院泌尿肛肠外科,山东武城253300

出　　处：《中华灾害救援医学》2025年第1期36-39,共4页Chinese Journal of Disaster Medicine

摘　　要：目的 探讨泌尿系结石术后合并感染性休克患者的急救中,采取经皮肾穿刺造瘘术和支架引流术的临床效果。方法 回顾性选取2022年8月至2024年1月武城县人民医院收治的60例泌尿系结石行腔内碎石术后合并感染性休克的患者,根据急救术式的不同分为研究组(支架引流术,30例)和对照组(经皮肾穿刺造瘘术,30例)。对比两组患者临床疗效情况、手术相关指标、临床症状消失时间、休克相关指标、炎症相关指标、尿常规指标、并发症发生情况。结果 与对照组患者相比,研究组患者的急救显效率较高(P<0.05);手术时间和住院时间更短,术中出血量更少,并发症总发生率更低(P值均<0.05)。治疗后,两组研究对象降钙素原、白细胞介素-6、中心静脉压、平均动脉压、尿量、血氧饱和度水平均较治疗前升高(P值均<0.05);尿红细胞计数和尿白细胞计数较治疗前降低(P值均<0.05)。且与对照组患者相比,研究组患者中心静脉压、平均动脉压、尿量、血氧饱和度水平升高更显著(P值均<0.05),降钙素原、白细胞介素-6、尿红细胞计数和尿白细胞计数水平降低更显著(P值均<0.05)。结论 在泌尿系结石术后合并感染性休克患者的急救中,实施支架引流术可显著缩短住院时间,促进患者休克、感染、以及尿常规的改善,临床疗效显著,安全性较高。Objective To explore the clinical efficacy of percutaneous nephrostomy and stent drainage in emergency treatment of patients with urinary tract stones complicated with septic shock after surgery.Methods A retrospective study was conducted on 60 patients with urinary tract stones complicated with septic shock after intracavitary lithotripsy admitted to Wucheng County People's Hospital from August 2022 to January 2024.They were divided into a study group(stent drainage,30 cases)and a control group(percutaneous nephrostomy,30 cases)according to different emergency procedures.Compare the clinical efficacy,surgical related indicators,time to disappearance of clinical symptoms,shock related indicators,inflammation related indicators,urine routine indicators,and incidence of complications between two groups of patients.Results Compared with the control group patients,the emergency response rate of the study group patients was higher(P<0.05);The surgery time and hospitalization time are shorter,the intraoperative bleeding is less,and the overall incidence of complications is lower(P values<0.05).After treatment,the levels of procalcitonin,interleukin-6,central venous pressure,mean arterial pressure,urine output,and blood oxygen saturation in both study groups increased compared to before treatment(P values<0.05);The urine red blood cell count and urine white blood cell count decreased compared to before treatment(both P values<0.05).Compared with the control group patients,the study group patients showed more significant increases in central venous pressure,mean arterial pressure,urine output,and blood oxygen saturation levels(all P values<0.05),and more significant decreases in procalcitonin,interleukin-6,urine red blood cell count,and urine white blood cell count levels(all P values<0.05).Conclusion In the emergency treatment of patients with urinary tract stones complicated with septic shock after surgery, the implementation of stent drainage can significantly shorten hospitalization time, promote the improvement of s

关 键 词：结石 感染性休克 急救 

分 类 号：R631.4[医药卫生—外科学]