摘要
目的:探讨输尿管置管联合输尿管软镜钬激光碎石治疗上尿路结石合并尿脓毒血症的治疗效果。方法:回顾性分析2016年7月-2018年7月收治35例上尿路结石急性梗阻合并尿脓毒血症患者的临床资料。结果:35例患者均成功将支架管置入肾盂,平均手术时间(8.5±3.47)min,置管后予以抗感染及对症治疗,患者感染症状迅速缓解,术后平均24 h疼痛评分(2.35±1.26)分,术后平均住院(6.64±3.52)d。2~4周后,所有患者重新入院行输尿管软镜钬激光碎石治疗,碎石过程顺利,平均手术时间(51.75±8.18)min,术后均未发生脓毒血症,术后平均住院(2.38±1.66)d,术后24 h疼痛评分(2.17±1.05)分。术后1 d行泌尿系CT检查,32例无残留结石,无石率91.43%;3例患者残留结石>4 mm,予以体外冲击波碎石。术后1个月内复查CT无残石,拔除双J管。结论:对于上尿路结石合并尿脓毒血症的患者,一期急诊留置输尿管支架管引流,二期行输尿管软镜钬激光碎石是一种安全、可行、微创、有效的治疗方法,值得推广。
Objective:To investigate the curative effect and the safety of ureteral stent implantation combined with flexible ureteroscopic holmium laser lithotripsy for upper urinary calculi with urinary sepsis.Method:Between July 2016 to July 2018,a total of 35 patients with acute obstruction of upper urinary calculi with urinary sepsis in our department were retrospectively analyzed.Result:The ureteral stents were successfully placed into the renal pelvis in 35 patients.The average operation time was(8.5±3.47)min.The overall infections were treated with anti-infection after the operation.The postoperative 24 h pain score and the average postoperative hospital stay were(2.35±1.26)and(6.64±3.52)days,respectively.All patients were re-admitted to flexible ureteroscopic holmium laser lithotripsy after 2-4 weeks.The operation time was(51.75±8.18)min.The hospitalization time was(2.38±1.66)days.The postoperative 24 h pain score was(2.17±1.05).At 1st day after surgery,the CT re-examinations showed that the average stone clearance rate was 91.43%.And we used the extracorporeal shock wave lithotripsy to treat the patients left.The CT re-examination within 1 month after surgery showed no residual stone,and the double J tube was removed.Conclusion:Our findings indicate that ureteral stent implantation combined with flexible ureteroscopic holmium laser lithotripsy for upper urinary calculi with urinary sepsis is safe and reliable,being worthy of application.
作者
尹永华
文博
夏安
尤洪科
YIN Yonghua;WEN Bo;XIA An;YOU Hongke(Department of Urology,Shenzhen Hospital of Integrated Traditional and West Medicine,Guang⁃zhou Medical University,Shenzhen 518104,China)
出处
《微创泌尿外科杂志》
2020年第3期186-190,共5页
Journal of Minimally Invasive Urology
关键词
输尿管软镜碎石术
上尿路结石
尿脓毒血症
flexible ureteroscope lithotripsy
upper urinary calculi
urine-derived sepsis
作者简介
通信作者:文博,tjwb001@126.com
