论文部分内容阅读
目的探讨急诊微创治疗上尿路梗阻伴尿脓毒症64例的临床效果及并发症。方法将2015年7月—2016年7月收治的上尿路梗阻伴尿脓毒症患者128例随机分为对照组和观察组各64例,对照组行B超引导经皮肾穿刺造瘘术,观察组行输尿管镜直视下逆行置入双J管引流术,比较两组治疗效果及并发症等情况,数据进行统计学处理,P<0.05为差异有统计学意义。结果观察组手术时间、出血量、引流时间、疼痛评分及尿脓毒症控制时间指标均优于对照组(均P<0.05),引流成功率90.63%、结石清除率93.75%均高于对照组(χ~2=6.043、5.687,均P<0.05),观察组术后并发症总发生率4.69%比对照组17.19%低(χ~2=5.133,P<0.05),两组术后血肌酐和尿素氮水平比较差异有统计学意义(χ~2=4.230、5.670,均P<0.05)。结论急诊微创输尿管镜直视下逆行置入双J管引流术治疗上尿路梗阻伴尿脓毒症的疗效显著,可缩短尿脓毒症控制时间,提高引流及结石清除率,减少术后并发症。
Objective To investigate the clinical effects and complications of emergency minimally invasive treatment of upper urinary tract obstruction with urinary sepsis in 64 cases. Methods From July 2015 to July 2016, 128 cases of upper urinary tract obstruction with urinary sepsis were randomly divided into control group and observation group, 64 cases in each group. The control group received B-guided percutaneous nephrostomy , The observation group underwent retrograde ureteroscopy under double J tube drainage, the treatment effect and complications were compared between the two groups, the data were statistically analyzed, P <0.05 for the difference was statistically significant. Results The operation time, bleeding volume, drainage time, pain score and urinary sepsis control time in the observation group were all better than those in the control group (all P <0.05). The drainage success rate was 90.63% and the stone clearance rate was 93.75% (χ ~ 2 = 6.043, 5.687, both P <0.05). The total incidence of postoperative complications was 4.69% in the observation group compared with 17.19% in the control group (χ ~ 2 = 5.133, And urea nitrogen levels were significantly different (χ ~ 2 = 4.230, 5.670, all P <0.05). Conclusions The retrograde double-J tube drainage in the treatment of upper urinary tract obstruction with urinary sepsis under the minimally invasive ureteroscopic retrograde operation has significant curative effect, which can shorten the control time of urinary sepsis, improve drainage and stone clearance rate and reduce postoperative complication.