摘要
目的探讨输尿管镜下逆行置入双J管在老年上尿路结石伴尿源性脓毒血症患者中的应用效果.方法选取我院2020年1月—2022年12月收治的70例老年上尿路结石伴尿源性脓毒血症患者为研究对象,按随机数字表法分为对照组与观察组,各35例.对照组采用输尿管镜下经皮肾穿刺造瘘引流术治疗,观察组采用输尿管镜下逆行置入双J管引流术治疗.比较两组患者的引流效果、临床相关指标、炎症水平及并发症发生情况.结果观察组肾积水减少量为(23.58±2.13)mm,多于对照组的(20.14±2.05)mm,术后引流管拔除时间为(3.89±0.42)d,短于对照组的(4.85±0.46)d,组间差异有统计学意义(P<0.05);观察组手术时间、腰痛缓解时间、术后下床活动时间、术后体温恢复正常时间均短于对照组,组间差异有统计学意义(P<0.05);术后3d,观察组C反应蛋白、降钙素原、白细胞计数、中性粒细胞比例水平均低于对照组,组间差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05).结论输尿管镜直视下逆行置入双J管引流术治疗老年上尿路结石伴尿源性脓毒血症效果更佳,可加快炎症消退,减少肾积水,缩短术后引流管拔除时间,且并发症少.
Objective To investigate the effect of retrograde placement of double J tube under ureteroscopy in elderly patients with upper urinary tract stones and urogenic sepsis.Methods 70 elderly patients with upper urinary tract stones and urogenic sepsis admitted to our hospital from January 2020 to December 2022 were selected as the study objects,and were divided into a control group and an observation group according to random number table method,with 35 cases in each group.The control group was treated with percutaneous nephrostomy under ureteroscope,and the observation group was treated with retrograde double J tube drainage under ureteroscope.The drainage effect,clinical indicators,inflammation level and complications were compared between the two groups.Results The reduction of hydronephrosis in the observation group was(23.58±2.13)mm,which was higher than(20.14±2.05)mm in the control group,and the removal time of postoperative drainage tube was(3.89±0.42)d,which was shorter than(4.85±0.46)d in the control group,the differences between groups were statistically significant(P<0.05);the time of operation,the time of relief of low back pain,the time of getting out of bed after operation and the time of temperature returning to normal after operation in the observation group were shorter than those in the control group,and the differences between the groups were statistically significant(P<0.05);3 days after surgery,C-reative protein,procalcitionin,white blood cel count and neutrophil ratio levels in the observation group were lower than those in the control group,and the differences between groups were statistically significant(P<0.05);the incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Retrograde placement of double J-tube drainage under ureteroscope is more effective in the treatment of elderly upper urinary tract stones with urogenic sepsis,which can accelerate the regression of inflammation,reduce the
作者
高茂
李国斌
徐国政
张建勇
谌华根
夏天成
倪娟
GAO Mao;LI Guobin;XU Guozheng;ZHANG Jianyong;CHEN Huagen;XIA Tiancheng;NI Juan(Department of Urology,Wuxi Eighth People's Hospital,Wuxi Jiangsu,214001,China)
出处
《反射疗法与康复医学》
2023年第15期121-124,共4页
Reflexology And Rehabilitation Medicine
关键词
上尿路结石
尿源性脓毒血症
输尿管镜
双J管引流术
经皮肾穿刺造瘘引流术
Upper urinary tract stones
Urinary sepsis
Ureteroscopy
Double J tube drainage surgery
Percutaneous nephrostomy and drainage
