经逆行置管引流和经皮肾穿刺造瘘引流在急诊治疗输尿管结石合并尿脓毒血症中的效果比较(1)
[摘要]目的 比较经逆行置管引流和经皮肾穿刺造瘘引流在急诊治疗输尿管结石合并尿脓毒血症中的效果。方法 选取2011年1月～2017年1月韶关市第一人民医院急诊室收治的80例输尿管结石合并尿脓毒血症患者作为研究对象，将其平均分成两组，每组各40例，对照组采用经皮肾穿刺造瘘引流进行急诊处理，研究组采用经逆行置管引流进行急诊处理，比较两组患者术后尿脓毒血症的控制时间、引流成功率以及并发症发生率。结果 两组患者术后尿脓毒血症控制时间、并發症发生率比较，差异无统计学意义(P>0.05)；研究组患者引流成功率明显高于对照组，差异有统计学意义(P<0.05)。结论 在输尿管结石合并尿脓毒血症急诊处理中，应用经逆行置管引流和经皮肾穿刺造瘘引流均能有效控制患者尿脓毒血症的进展和避免患者术后发生较多的不良并发症，但经逆行置管引流的成功率更高，因此，为保证患者能够得到及时的急诊治疗，可首选经逆行置管引流。
[关键词]经逆行置管引流；经皮肾穿刺造瘘引流；输尿管结石；尿脓毒血症
[中图分类号] R693.4 [文献标识码] A [文章编号] 1674-4721(2018)5(a)-0073-03
[Abstract]Objective To compare the efficacy of retrograde catheter drainage and percutaneous nephrolithotomy in the emergency treatment of ureteral calculi complicated with urinary sepsis.Methods Eighty patients with ureteral calculi complicated with urinary sepsis admitted to the emergency department of the First People′s Hospital of Shaoguan City from January 2011 to January 2017 were selected as the subjects，and divided into two groups by average，40 cases in each group.The control group was treated with percutaneous nephrostomy drainage，and the patients in the research group were treated by retrograde catheter drainage for emergency treatment.Urinary sepsis control time，drainage success rate and complication rate were compared between the two groups.Results There was no significant difference in postoperative urinary sepsis control time and incidence of complications between the two groups (P>0.05).The success rate of drainage in research group was significantly higher than that in control group，the difference was significant (P<0.05).Conclusion In the emergency treatment of ureteral calculi combined with urinary sepsis，the application of retrograde catheter drainage and percutaneous nephroureterectomy can effectively control the progression of urinary sepsis and avoid the occurrence of more postoperative adverse reactions in patients Complications，but the success rate of retrograde catheter drainage is higher，therefore，in order to ensure that patients can get timely emergency treatment，may be preferred by retrograde catheter drainage.
[Key words]Retrograde catheter drainage；Percutaneous nephrostomy drainage；Ureteral calculi；Urinary sepsis
输尿管结石合并尿脓毒血症属于严重的尿路感染疾病，其中输尿管结石多由上尿路梗阻所致，继而引发患者出现尿道感染，感染未及时控制或发展严重时，便易引发患者出现感染性休克或尿脓毒血症[1-3]。此时，患者病情危急，需及时对患者进行急诊治疗，但不宜采用开放手术治疗，原因是其侵袭性较大，为此现代临床多采用经逆行置管引流和经皮肾穿刺造瘘引流术对患者进行急诊处理，并取得了良好的治疗效果[4-5]。本文主要对比了经逆行置管引流和经皮肾穿刺造瘘引流在急诊处理输尿管结石合并尿脓毒血症的疗效，现报道如下。
1资料与方法
1.1一般资料
选取2011年1月～2017年1月韶关市第一人民医院急诊室收治的80例输尿管结石合并尿脓毒血症患者作为研究对象，患者均经临床确诊，该项研究已经过医院医学伦理委员会批准，且患者在治疗前均签署知情同意书。将患者平均分成两组，每组各40例。对照组男23例，女17例；平均年龄(39.4±2.8)岁；输尿管结石长径(11.4±3.5)mm；病程时间(2.3±1.0)年；术前抗生素使用时间(3.4±1.2)d；外周血白细胞计数(15.5±2.3)×109/L；其中轻度感染13例，中度感染21例，重度感染6例。研究组男21例，女19例；平均年龄(38.7±2.6)岁；输尿管结石长径(11.2±3.6)mm；病程时间(2.4±1.3)年；术前抗生素使用时间(3.5±1.0)d；外周血白细胞计数(15.3±2.6)×109/L；其中轻度感染12例，中度感染23例，重度感染5例。两组患者的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(谭益元 林瑜 熊莽 郭辉 潘伟民 )
[关键词]经逆行置管引流；经皮肾穿刺造瘘引流；输尿管结石；尿脓毒血症
[中图分类号] R693.4 [文献标识码] A [文章编号] 1674-4721(2018)5(a)-0073-03
[Abstract]Objective To compare the efficacy of retrograde catheter drainage and percutaneous nephrolithotomy in the emergency treatment of ureteral calculi complicated with urinary sepsis.Methods Eighty patients with ureteral calculi complicated with urinary sepsis admitted to the emergency department of the First People′s Hospital of Shaoguan City from January 2011 to January 2017 were selected as the subjects，and divided into two groups by average，40 cases in each group.The control group was treated with percutaneous nephrostomy drainage，and the patients in the research group were treated by retrograde catheter drainage for emergency treatment.Urinary sepsis control time，drainage success rate and complication rate were compared between the two groups.Results There was no significant difference in postoperative urinary sepsis control time and incidence of complications between the two groups (P>0.05).The success rate of drainage in research group was significantly higher than that in control group，the difference was significant (P<0.05).Conclusion In the emergency treatment of ureteral calculi combined with urinary sepsis，the application of retrograde catheter drainage and percutaneous nephroureterectomy can effectively control the progression of urinary sepsis and avoid the occurrence of more postoperative adverse reactions in patients Complications，but the success rate of retrograde catheter drainage is higher，therefore，in order to ensure that patients can get timely emergency treatment，may be preferred by retrograde catheter drainage.
[Key words]Retrograde catheter drainage；Percutaneous nephrostomy drainage；Ureteral calculi；Urinary sepsis
输尿管结石合并尿脓毒血症属于严重的尿路感染疾病，其中输尿管结石多由上尿路梗阻所致，继而引发患者出现尿道感染，感染未及时控制或发展严重时，便易引发患者出现感染性休克或尿脓毒血症[1-3]。此时，患者病情危急，需及时对患者进行急诊治疗，但不宜采用开放手术治疗，原因是其侵袭性较大，为此现代临床多采用经逆行置管引流和经皮肾穿刺造瘘引流术对患者进行急诊处理，并取得了良好的治疗效果[4-5]。本文主要对比了经逆行置管引流和经皮肾穿刺造瘘引流在急诊处理输尿管结石合并尿脓毒血症的疗效，现报道如下。
1资料与方法
1.1一般资料
选取2011年1月～2017年1月韶关市第一人民医院急诊室收治的80例输尿管结石合并尿脓毒血症患者作为研究对象，患者均经临床确诊，该项研究已经过医院医学伦理委员会批准，且患者在治疗前均签署知情同意书。将患者平均分成两组，每组各40例。对照组男23例，女17例；平均年龄(39.4±2.8)岁；输尿管结石长径(11.4±3.5)mm；病程时间(2.3±1.0)年；术前抗生素使用时间(3.4±1.2)d；外周血白细胞计数(15.5±2.3)×109/L；其中轻度感染13例，中度感染21例，重度感染6例。研究组男21例，女19例；平均年龄(38.7±2.6)岁；输尿管结石长径(11.2±3.6)mm；病程时间(2.4±1.3)年；术前抗生素使用时间(3.5±1.0)d；外周血白细胞计数(15.3±2.6)×109/L；其中轻度感染12例，中度感染23例，重度感染5例。两组患者的一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(谭益元 林瑜 熊莽 郭辉 潘伟民 )
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