摘要
目的 比较微创经皮肾造瘘与输尿管镜下置管治疗孤立肾结石积脓的临床疗效.方法 回顾性分析2013年1月至2018年5月郑州大学第五附属医院收治的38例孤立肾结石积脓患者的临床资料.按手术方式将患者分为A组（微创经皮肾穿刺造瘘,20例）和B组（输尿管镜下逆行置管引流,18例）,对两种治疗方法的优劣性进行评价.结果 两组患者年龄、性别及发病时间、病史情况、术前感染情况、肾盂积水程度等一般资料比较差异未见统计学意义（P〉0.05）.A组术后感染控制情况、肾功能改善及手术疗效优于B组,差异有统计学意义（P〈0.05）;A组手术用时少于B组（P〈0.05）;两组术后并发症比较差异未见统计学意义（P〉0.05）.结论 微创经皮肾造瘘治疗孤立肾结石合并肾盂感染效果优于输尿管镜下置管引流,但孤立肾患者的病情较为特殊,应根据其临床情况行个体化治疗.
Objective To compare the clinical efficacy between minimally invasive percutaneous nephrostomy and ureteroscopy on solitary nephrolithiasis and pyonephrosis .Methods The clinical data of 38 patients with solitary kidney stones empyema treated in the Fifth Affiliated Hospital of Zhengzhou University from January 2013 to May 2018 were retrospectively analyzed .Patients were divided into group A （ treated by minimally invasive percutaneous nephrostomy , 20 cases ） and group B （ treated by retrograde catheter drainage under ureteroscope , 18 cases ） according to surgical procedures .And the advantages and disadvantages of the two treatment methods were evaluated .Results There was no significant difference in general data , such as age , gender , duration of onset , history of illness , preoperative infection and hydronephrosis , between the two groups （ P〉0.05 ） .Postoperative infection control , renal function improvement and surgical effect in group A were better than those in group B , the difference was statistically significant （ P〈0.05 ） .The surgical time in group A was shorter than that in group B （ P〈0.05） .There was no significant difference in postoperative complications between the two groups （ P〉0.05 ） .Conclusions Minimally invasive percutaneous nephrostomy has better therapeutic effect than ureteroscopic catheter drainage for solitary nephrolithiasis complicated by renal pelvis infection.However, the condition of patients with isolated kidneys is special , so that individualized treatment should be implemented based on the patient＇s clinical condition .
作者
张英豪
康郑军
郑立传
徐文博
于洋
Zhang Yinghao;Kang Zhengjun;Zheng Lichuan;Xu Wenbo;Yu Yang(Department of Urology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国实用医刊》
2018年第21期19-22,共4页
Chinese Journal of Practical Medicine
关键词
孤立肾
急性梗阻
积脓
肾造瘘
输尿管镜
Isolated kidney
Acute obstruction
Empyema
Minimally invasive percutaneous nephrostomy
Ureteroscopy
