枸橼酸氢钾钠对预防留置双J管术后尿路感染的临床研究

Clinical Study of Sodium Potassium Hydrogen Citrate on Prevention of Urinary Tract Infection After Indwelling Double J Tube Operation

目的研究枸橼酸氢钾钠用于预防留置双J管术后尿路感染的临床效果。方法选取2020年1月—2022年2月100例在广州市第十二人民医院手术且术后留置双J管的患者作为研究对象,采取随机数字表法的原则对其进行分组,每组各50例。对照组患者未服用药物,观察组患者口服枸橼酸氢钾钠,比较两组的术后尿路感染发生率、血尿相关指标、时间指标、术后并发症发生率、术后结石复发率、尿液相关指标(pH值、尿酸)。结果术后尿路感染:观察组的术后尿路感染发生率低于对照组,差异有统计学意义(P<0.05);血尿指标:观察组治疗后的血白细胞、尿白细胞、尿β2微球蛋白和血清降钙素原水平均低于治疗前和对照组,差异有统计学意义(P<0.05);时间指标:观察组的结石排净时间和术后住院时间均短于对照组,差异有统计学意义(P<0.05);术后并发症:观察组的术后并发症总发生率低于对照组,差异有统计学意义(P<0.05);结石复发风险:两组术后3个月和术后6个月的结石复发率比较,差异无统计学意义(P>0.05),但观察组术后12个月的结石复发率低于对照组,差异有统计学意义(P<0.05);尿液相关指标:观察组治疗后的pH值大于治疗前且大于对照组,差异有统计学意义(P<0.05),两组患者治疗后的尿酸水平均小于治疗前,但治疗后组间比较差异无统计学意义(P>0.05)。结论留置双J管患者口服枸橼酸氢钾钠更有利于预防术后尿路感染的发生率,且有利于改善血尿指标,降低并发症发生风险,缩短结石排净时间和术后住院时间。同时,口服枸橼酸氢钾钠也有利于预防术后结石的复发,综合疗效显著,有借鉴意义和临床推广价值。

Objective To study the clinical effect of sodium potassium hydrogen citrate in preventing urinary tract infection after indwelling double J tube.Methods A total of 100 patients who underwent surgery in the Guangzhou Twelfth People’s Hospital from January 2020 to February 2022 and had double J tube indwells after surgery were selected as research objects,and they were divided into groups based on the principle of random number table method,with 50 cases in each group.The control group took no drugs,and the observation group took sodium potassium hydrogen citrate orally.The incidence of postoperative urinary tract infection,hematuria related indexes,time indexes,postoperative complication rate,postoperative stone recurrence rate,urine related indexes(pH value,uric acid)of the two groups were compared.Results Postoperative urinary tract infection,the incidence of postoperative urinary tract infection in the observation group was lower than that in the control group,with statistical significance(P<0.05).Hematuria indexes,after treatment,the average levels of white blood cells,urinary white blood cells,urinaryβ2 microglobulin and serum calcitonin raw water in observation group were lower than before treatment and control group,with statistical significance(P<0.05).Time indexes,the calculi clearing time and postoperative hospital stay in the observation group were shorter than those in the control group,with statistical significance(P<0.05).Postoperative complications,the total incidence of postoperative complications in observation group was lower than that in control group,with statistical significance(P<0.05).Risk of stone recurrence,there was no statistical significance in the stone recurrence rate of 3 months and 6 months after surgery between the two groups(P>0.05),but the stone recurrence rate of 12 months after surgery in the observation group was lower than that in the control group,with statistical significance(P<0.05).Urine related indexes,the pH value of the observation group after treatment was higher than that before treatment and greater than that of the control group,showing statistical significance(P<0.05).The uric acid level of the two groups after treatment was lower than that before treatment,but there was no statistical significance between the two groups after treatment(P>0.05).Conclusion Oral potassium sodium citrate is more beneficial to prevent the incidence of postoperative urinary tract infection,improve hematuria index,reduce the risk of complications,shorten the time of stone expulsion and postoperative hospital stay in patients with indenture double J tube.At the same time,oral administration of sodium potassium hydrogen citrate is also conducive to the prevention of postoperative stone recurrence,the comprehensive effect is significant,has reference significance and clinical promotion value.