双J管留置时间对输尿管结石患者感染治疗效果的影响研究

发布时间：2019-02-28 14:55

【摘要】：目的探讨双J管留置时长对输尿管结石并发感染患者治疗效果的影响,为临床应用提供参考依据。方法选取2012年1月-2016年3月医院收治的123例输尿管结石并发感染患者为研究对象,入院后首先在输尿管硬镜下置入双J管,后行输尿管镜下钬激光碎石术或经皮肾镜碎石术清除结石;根据双J管留置时长分为7d组(58例)与7d组(65例),比较两组的基线资料及手术资料。结果共检出病原菌33株,其中革兰阴性菌感染最多,占66.7%;两组患者性别、年龄、体质指数、病程、体温、血、尿白细胞(WBC)计数等基线资料相比,差异无统计学意义,具有可比性;两组患者留置双J管当天的尿WBC计数、留置第7天的血、尿WBC计数及发热等资料相比,差异无统计学意义;两组患者的手术时间、手术方式、术后住院时间、术后30d的结石清除率、术后并发症发生率及Clavien-Dindo分级等手术资料比较,差异无统计学意义。结论双J管留置时长对输尿管结石并发感染患者的治疗效果和安全性无显著影响,建议尽可能在留置7d后拔除,尽早进行结石手术。
[Abstract]:Objective To study the effect of double-J-tube indwelling time on the treatment of patients with ureteral calculi and to provide reference for clinical application. Methods 123 cases of ureteral stone complicated with infection were selected from January 2012 to March 2016. After admission, a double-J tube was first placed under the rigid ureteroscope, and the stones were removed by ureteroscopy, laser lithotripsy or percutaneous nephrolithotomy. The baseline data and operative data of the two groups were compared according to the length of the double J tube in 7 days (58 cases) and 7 days (65 cases). Results 33 strains of pathogenic bacteria were detected, among which, the infection of gram-negative bacteria was the most, accounting for 66.7%, and the differences of sex, age, body mass index, course of course, body temperature, blood and urine white blood cell (WBC) of the two groups were not statistically significant and were comparable. The urine WBC count on the day of indwelling double-J tube in the two groups was not statistically significant compared with the data such as blood, urine WBC count and fever in the 7th day. The operation time, the operation mode, the post-operative hospital stay time and the stone clearance of 30 days after operation in the two groups were not statistically significant. There was no significant difference in the incidence of postoperative complications and the surgical data such as Clavidien-Dindo classification. Conclusion The duration of the double-J-tube indwelling time has no significant effect on the treatment effect and safety of the patients with ureteral stone complicated with infection, and it is suggested that the stone operation should be performed as soon as possible after the indwelling for 7 days.
【作者单位】：广州医科大学附属第五医院泌尿外科;广州医科大学微创外科技术和产品转化中心;
【基金】：广州市卫生厅医药科技计划基金资助项目(201645532) 广东省临床教学基地教学改革研究项目(2015JDB085)
【分类号】：R699.4

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