HIV/AIDS合并泌尿外科疾病腔镜手术的安全性探讨

The safety of endoscopic surgery for HIV/AIDS patients combined with urologic diseases

目的探讨人类免疫缺陷病毒感染者/艾滋病患者(HIV/AIDS)合并泌尿外科疾病进行腔镜手术的安全性。方法自2015年5月至2018年4月我院对HIV/AIDS合并泌尿外科疾病患者92例施行各类腔镜手术,对其临床资料进行回顾性分析。结果共施行92例泌尿外科腔镜手术,其中输尿管镜下碎石取石术21例、经皮肾镜碎石取石术34例、经尿道手术31例、腹腔镜手术6例。术前及术后患者白细胞、血小板、C-反应蛋白、CD4淋巴细胞计数差异无统计学意义,5例患者术后出现发热,其中1例出现脓毒血性休克,所有患者经治疗后病情好转,围手术期无死亡病例。术中发生1例职业暴露,未发现HIV感染。结论 HIV/AIDS合并泌尿系外科疾病患者进行腔镜手术,充分做好围手术期准备,对于医患而言,总体是安全的。

Objective To evaluate the safety of endoscopic treatment of HIV/AIDS patients combined with urologic diseases. Methods Kinds of endoscopic surgery were performed on 92 patients with HIV/AIDS combined with urologic diseases in our hospital from May 2015 to April 2018. The clinical data were analyzed retrospectively. Results A total of 92 cases of urologic endoscopic surgery were performed, including 21 cases of ureteroscopic lithotripsy, 34 cases of percutaneous nephro lithotripsy, 31 cases of transurethral surgery and 6 cases of laparoscopic surgery. There were no differences between preoperative and postoperative with patients＇ white blood cells, platelets, C-reactive protein and CD4 lymphocyte count, Five patients got fever after surgery, One of them developed septic shock, all patients were recovery after treatment, no deaths were found during perioperative period. One case of occupational exposure occurred intraoperatively and no HIV infection was found. Conclusion Endoscopic surgery is generally safe for patients with AIDS combined with urologic diseases and doctors if they are fully prepared for perioperative period.