输尿管软镜下腔内碎石术对上尿路结石的碎石效果及尿源性脓毒血症发生的影响

doi:10.3969/j.issn.1671-7171.2023.02.012

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摘要【目的】探讨输尿管软镜下腔内碎石术用于上尿路结石的疗效及对尿源性脓毒血症发生的影响。【方法】入住本院的120例上尿路结石患者,随机分为对照组和观察组,每组60例。对照组采用经皮肾镜取石术,观察组采用输尿管软镜下腔内碎石术,比较两组患者手术情况、临床疗效、感染相关指标及尿源性脓毒血症发生率。【结果】观察组手术时间短于对照组,术中出血量少于对照组,术后住院时间短于对照组,且差异均有统计学意义(P<0.05);观察组尿源性脓毒血症发生率低于照组,碎石成功率、结石清除率高于对照组,且差异有统计学意义(P<0.05);观察组患者术后2 h白细胞计数(WBC)、中性粒细胞计数(N)、血清降钙素原(PCT)均低于对照组(P<0.05)。【结论】输尿管软镜下腔内碎石术用于上尿路结石术患者,具有更优的碎石成功率、结石清除率,患者术后感染风险低,且对尿源性脓毒血症发生具有一定的预防价值。

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	冯伟
	吕忠

关键词 ：尿路结石症/外科学, 输尿管镜检查, 尿路结石症/并发症, 脓毒症/并发症, 治疗结果

Abstract：【Objective】To analyze the effect of ureteroscopic intraluminal lithotripsy on upper urinary calculi and prevention of sepsis. 【Methods】A total of 120 patients with upper urinary calculi were divided into the control group and the observation group,with 60 cases in each group. Patients in the control group received percutaneous nephrolithotripsy,while patients in thr observation group were treated with ureteroscopic intraluminal lithotripsy. Surgical conditions,clinical efficacy,infection-related indicators and incidence of urogenic sepsis were compared between the two groups. 【Results】The operation time in the observation group was shorter than that in the control group. The intraoperative blood loss in the observation group was less than that in the control group; And postoperative hospital time was shorter than that in the control group as well. The differences were statistically significant (P<0.05). The gravel success rate and stone clearance rate in the observation group were higher than those in the control group. Postoperative 2 h leukocyte count (WBC), neutrophil count (N) and serum Calcitonogen (PCT) in the observation group were lower than those in the control group (P<0.05). 【Conclusion】Uteroscopic endoscopic lithotripsy is used in patients with upper urinary calculi,which provides higher s gravel success rate and better stone removal rate,and reduce the risk of postoperative infection.It has certain clinical value for the prevention of urogenic sepsis.

Key words： Urolithiasis/SU Ureteroscopy Urolithiasis/ CO Sepsis/CO Treatment Outcome

收稿日期: 2022-10-20

中图分类号:

R691.4

通讯作者: *E-mail:lzabc0105@163.com

引用本文:

冯伟, 吕忠. 输尿管软镜下腔内碎石术对上尿路结石的碎石效果及尿源性脓毒血症发生的影响[J]. 医学临床研究, 2023, 40(2): 202-204.
FENG Wei, LYU Zhong. Effect of Ureteroscopic Intraluminal Lithotripsy on Upper Urinary Tract Stones and Urinary Sepsis. JOURNAL OF CLINICAL RESEARCH, 2023, 40(2): 202-204.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.02.012 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I2/202

[1] XIONG M,ZHU X,CHEN D,et al. Post ureteroscopic stone surgery ureteral strictures management:a retrospective study[J].Int Urol Nephrol,2020,52(5):841-849.
[2] 徐宏博,魏雪栋,胡林昆,等. 快速序贯器官衰竭评分对经皮肾镜取石术后脓毒症休克的预测价值[J].中华泌尿外科杂志,2021,42(5):332-338.
[3] CHUGH S,PIETROPAOLO A,MONTANARI E,et al. Predictors of urinary infections and urosepsis after ureteroscopy for stone disease:a systematic review from eau section of urolithiasis (EULIS)[J].Curr Urol Rep,2020,21(4):16.
[4] WEI C,WANG T,CHEN S,et al. Concomitant management of renal calculi and recurrent ureteropelvic junction obstruction with percutaneous nephrolithotomy and antegrade balloon dilation[J].J Int Med Res,2020,48(5):300060520911252.
[5] 唐伟. 2017年欧洲泌尿外科学会尿脓毒血症诊疗指南解读[J].重庆医科大学学报,2018,43(4):480-481.
[6] LIU J Y,DICKTER J K. Nosocomial infections:a history of hospital-acquired infections[J].Gastrointest Endosc Clin N Am,2020,30(4):637-652.
[7] GüLER Y,ERBIN A,OZMERDIVEN G,et al. Comparison of retrograde intrarenal surgery and laparoscopic surgery in the treatment of proximal ureteral and renal pelvic stones greater than 15 mm[J].Folia Med (Plovdiv),2020,62(3):490-496.
[8] 陈忠军,周家杰,沈昊. 术中肾盂尿和结石细菌培养及药敏试验对预防经皮肾镜取石术后尿脓毒血症的价值研究[J].中国全科医学,2020,23(14):1753-1759.
[9] PALLKA J,FAROOQ Z,ANDERSON B G. Safety of retrograde pyelography for infected ureteral stones[J].Can J Urol,2020,27(1):10130-10134.
[10] WANG B,TIAN Y,PENG Y,et al. Comparative study of retroperitoneal laparoscopic versus open ipsilateral nephrectomy after percutaneous nephrostomy:a multicenter analysis[J].J Laparoendosc Adv Surg Tech A,2020,30(5):520-524.
[11] 杨登科,张绍辉,高喆,等. 术前未预置双J管一期输尿管软镜碎石治疗上尿路结石的疗效观察[J].中国内镜杂志,2019,25(6):56-61.
[12] 赵金全,张丽. 电子输尿管软镜钬激光碎石治疗上尿路结石[J].中国微创外科杂志,2019,19(6):573-576.
[13] ALLAMEH F,RAZZAGHI M,FALLAH-KARKAN M,et al. Comparison of stone retrieval basket,stone cone and holmium laser:which one is better in retropulsion and stone-free status for patients with upper ureteral calculi?[J].J Lasers Med Sci,2019,10(3):179-184.