摘要
目的探讨微创技术治疗急性输尿管结石梗阻致肾感染的临床疗效。方法自2007年5月至2011年9月,对26例急性输尿管结石梗阻导致肾感染患者行微创手术治疗。26例均有患侧腰腹部疼痛,有不同程度发热,体温介于37.3～39.7℃之间。所有患者术前均接受抗感染、对症支持等常规治疗3～7d,其中10例感染症状好转,随后接受微创手术碎石;另外16例经常规治疗后感染情况未明显好转,而先行输尿管置管(7例)或经皮肾穿刺造瘘(9例)引流尿液,待感染情况好转后再接受微创手术。患者均接受经尿道输尿管镜取石术或经皮肾镜取石术。结果 19例行经尿道输尿管镜取石术,7例经皮肾镜取石术。手术均成功解除尿路梗阻,结石取净率95.2%。术中无输尿管穿孔、大出血、气胸、尿外渗、肾周血肿、腹腔脏器损伤等并发症发生。术后2～8d后,所有患者体温和血白细胞数降至正常。随访3～12个月,患侧肾无萎缩,无输尿管狭窄发生。结论在有效控制感染的情况下,采用微创技术治疗急性输尿管结石合并肾感染,具有创伤小、安全性高、效果好等优点,可作为结石合并肾感染的一种治疗选择。
Objective To investigate the clinical effect of minimally invasive techniques for treating acute obstructive ureteral calculi which caused renal infection. Methods From May 2007 to Sep 2011, 26 patients underwent minimally invasive management for ureteral calculi combined renal infection. The data of these 26 cases were reviewed retrospectively. All the patients suffered from loin pain and fever （37.3- 39.7℃）. Ten of them underwent minimally invasive treatment after anti-infection therapy for3-7 days, the other 16 cases underwent dwelling ureteral stent （7 cases） or percutaneous nephrostomy （9 cases） in the first period because of intractable pain or fever, then received ureteroscopic lithotripsy or percutaneous nephros- tomy lithotripsy when the situation improved. Results Nineteen patients were treated with ureteroscopic lithotripsy, 7 received percutaneous nephrostomy lithotripsy. All of the patients were treated successfully, the stone-free rate was 95.2%. No severe complications such as ureteral perforation, massive hemorrhage, or high fever occurred. The body temperature and blood white cell counts returned to normal range 2 to 8 days after operation. The patients were followed up for 3 to 12 months, no atrophy of kidney or ureteral stenosis was recorded. Conclusions Minimally invasive techniques is safe and effective for the treatment of acute obstructive ureteral calculi combined with renal infection.
出处
《中华腔镜泌尿外科杂志（电子版）》
2012年第3期41-44,共4页
Chinese Journal of Endourology(Electronic Edition)
基金
广东省东莞市科技计划资助项目(201110515001078)
关键词
结石
尿路梗阻
感染
微创技术
经皮肾镜碎石术
输尿管镜碎石术
Calculi
Urinary obstruction
Infection
Minimally invasive technique
Percutaneous nephrostomy lithotripsy
Ureteroscopic lithotripsy
