输尿管软镜钬激光碎石术治疗肾盏憩室结石术后全身炎症反应综合征及残石存在的研究

发布时间：2018-02-27 12:32

本文关键词： 肾结石输尿管镜检查全身炎症反应综合征影响因素分析　出处：《中国全科医学》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨输尿管软镜钬激光碎石术治疗肾盏憩室结石术后全身炎症反应综合征(SIRS)和残石存在发生情况。方法选取2012年9月—2015年7月郑州大学第二附属医院诊断为肾盏憩室结石的患者共30例为研究对象,所有患者经肾-输尿管-膀胱摄影(KUB)+静脉肾盂造影(IVP)或CT尿路造影(CTU)检查后诊断为肾盏憩室结石并行输尿管软镜钬激光碎石术治疗。记录术后SIRS发生情况,术后1个月及3个月复查双肾CT平扫了解残石存在情况。结果手术时间(67.3±21.2)min,术中出血量(7.0±4.1)ml,术后住院天数(4.1±2.7)d。术后发生SIRS 6例(20.0%),给予积极抗感染、补液等对症处理后均未发生尿脓毒血症及感染性休克。术后1个月残石存在6例,残石存在率为20.0%;术后3个月残石存在5例,残石存在率为16.7%。不同性别、年龄、结石直径、结石位置、结石数量、肾盂肾盏夹角患者SIRS发生情况比较,差异均无统计学意义(P0.05);是否合并糖尿病、术中有无感染迹象、是否有感染性结石成分患者SIRS发生情况比较,差异均有统计学意义(P0.05)。不同性别、年龄、结石直径、结石数量、是否合并糖尿病、术中有无感染迹象、是否有感染性结石成分患者术后残石存在发生情况比较,差异均无统计学意义(P0.05);不同结石位置、肾盂肾盏夹角患者术后残石存在发生情况比较,差异均有统计学意义(P0.05)。结论输尿管软镜钬激光碎石术是目前治疗肾盏憩室结石比较安全、有效的方法之一,但对有发生SIRS危险因素的患者要注意术后感染的防治。对有残石存在危险因素的患者要做好术前手术方式的选择及术后排石的工作。
[Abstract]:Objective to investigate the occurrence of systemic inflammatory response syndrome (SIRS) and residual stone after ureteral soft endoscope holmium laser lithotripsy in the treatment of calyceal diverticulum calculi. A total of 30 patients with Calendula diverticulum calculi were studied. All patients were treated with ureteral diverticulithiasis and ureteral soft endoscopy with holmium: YAG laser lithotripsy after renal uretero-cystoscopy (KUB) intravenous pyelography (IVP) or CT urography (CTU). The incidence of SIRS after operation was recorded. Results the operative time was 67.3 卤21.2 min, the intraoperative bleeding volume was 7.0 卤4.1 ml, and the postoperative hospital stay was 4.1 卤2.7 days. SIRS occurred in 6 cases (20.0%). There were no urinary sepsis and septic shock after resuscitation, 6 cases had residual stone and 20.0 residual stone, 5 cases had residual stone and 16.7T, different sex, age, diameter of stone, 3 months after operation, There was no significant difference in the location of stones, the number of stones and the incidence of SIRS in patients with renal pelvis and calyceal angle. The difference was statistically significant (P 0.05). A comparison of the occurrence of residual stone in patients with different sex, age, stone diameter, stone number, diabetes mellitus, infection during operation, and residual stone after operation was made. There was no significant difference between the two groups (P 0.05), and there was no significant difference in the occurrence of residual stone in patients with different stone locations and the angle between renal pelvis and calyceal. Conclusion the ureteral soft endoscope holmium: YAG laser lithotripsy is a safe method for the treatment of calculus in calyceal diverticulum. One of the effective methods is to pay attention to the prevention and treatment of postoperative infection in patients with SIRS risk factors.
【作者单位】：郑州大学第二附属医院泌尿外科;
【分类号】：R459.7;R699.2

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