经逆行置管引流和经皮肾穿刺造瘘引流在急诊治疗输尿管结石合并尿脓毒血症中的效果比较

Comparison of the effects of retrograde catheter drainage and percutaneous nephrostomy in emergency treatment of ureteral calculi combined with urinary sepsis

目的比较经逆行置管引流和经皮肾穿刺造瘘引流在急诊治疗输尿管结石合并尿脓毒血症中的效果。方法选取2011年1月~2017年1月韶关市第一人民医院急诊室收治的80例输尿管结石合并尿脓毒血症患者作为研究对象,将其平均分成两组,每组各40例,对照组采用经皮肾穿刺造瘘引流进行急诊处理,研究组采用经逆行置管引流进行急诊处理,比较两组患者术后尿脓毒血症的控制时间、引流成功率以及并发症发生率。结果两组患者术后尿脓毒血症控制时间、并发症发生率比较,差异无统计学意义(P>0.05);研究组患者引流成功率明显高于对照组,差异有统计学意义(P<0.05)。结论在输尿管结石合并尿脓毒血症急诊处理中,应用经逆行置管引流和经皮肾穿刺造瘘引流均能有效控制患者尿脓毒血症的进展和避免患者术后发生较多的不良并发症,但经逆行置管引流的成功率更高,因此,为保证患者能够得到及时的急诊治疗,可首选经逆行置管引流。

Objective To compare the efficacy of retrograde catheter drainage and percutaneous nephrolithotomy in the emergency treatment of ureteral calculi complicated with urinary sepsis.Methods Eighty patients with ureteral calculi complicated with urinary sepsis admitted to the emergency department of the First People′s Hospital of Shaoguan City from January 2011 to January 2017 were selected as the subjects,and divided into two groups by average,40 cases in each group.The control group was treated with percutaneous nephrostomy drainage,and the patients in the research group were treated by retrograde catheter drainage for emergency treatment.Urinary sepsis control time,drainage success rate and complication rate were compared between the two groups.Results There was no significant difference in postoperative urinary sepsis control time and incidence of complications between the two groups（P〈0.05）.The success rate of drainage in research group was significantly higher than that in control group,the difference was significant（P〈0.05）.Conclusion In the emergency treatment of ureteral calculi combined with urinary sepsis,the application of retrograde catheter drainage and percutaneous nephroureterectomy can effectively control the progression of urinary sepsis and avoid the occurrence of more postoperative adverse reactions in patients Complications,but the success rate of retrograde catheter drainage is higher,therefore,in order to ensure that patients can get timely emergency treatment,may be preferred by retrograde catheter drainage.