摘要
目的:分析不同时机行经皮肾穿刺造瘘术(PCN)引流治疗上尿路结石伴感染的效果。方法:将本院2019年10月至2024年10月接收的102例上尿路结石伴感染患者按照行PCN引流治疗的时机不同分为2h组(n=42,入院后2h内行PCN引流治疗)、12h组(n=34,入院后2~12h内行PCN引流治疗)及24h组(n=26,入院后12~24h内行PCN引流治疗)。对比三组的手术时间、术中出血量及一次穿刺成功率,比较三组术前及术后3d的体温变化、感染相关指标[白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)]水平变化,记录三组的感染控制时间、住院时间及并发症情况。结果:三组的手术时间、术中出血量及一次穿刺成功率比较差异无统计学意义(P>0.05);2h组和12h组的住院时间均短于24h组(P<0.05),但2h组和12h组间感染控制时间及住院时间比较差异无统计学意义(P>0.05)。术后3d,三组的体温、WBC、CRP、PCT水平均低于术前(P<0.05),且24h组的体温、WBC、CRP、PCT高于2h组和12h组(P<0.05),但2h组和12h组各指标比较差异无统计学意义(P>0.05)。三组并发症发生情况比较差异无统计学意义(P>0.05)。结论:入院后12h内PCN引流治疗上尿路结石伴感染患者的效果更优,可有效控制感染,缩短住院时间。
Objective:To analyze the efficacy of percutaneous nephrostomy(PCN)drainage in the treatment of upper urinary tract stones with infection at different timeing.Methods:Totally 102 patients with upper urinary tract calculi and infection in the hospital from October 2019 to October 2024 were divided into 2h group(n=42,PCN drainage within 2h after admission),12h group(n=34,PCN drainage within 2~12h after admission)and 24h group(n=26,PCN drainage within 12~24h after admission)according to the different timing of PCN drainage.The surgical time,intraoperative blood loss and one-time puncture success rate,and changes of body temperature and infection-related indicators[white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT)]before surgery and at 3 days after operation were compared among the three groups.The infection control time,hospitalization time and complications in the three groups were recorded.Results:There were no statistical differences in surgical time,intraoperative blood loss and success rate of one-time puncture among the three groups(P>0.05).The hospitalization time in the 2h and 12h groups was shorter than that in the 24h group(P<0.05),but no statistical differences were observed in infection control time and hospitalization time between the 2h group and the 12 h group(P>0.05).At 3 days after surgery,the body temperature,WBC,CRP and PCT in the three groups were lower than those before surgery(P<0.05),and the above indicators in the 24h group were higher than those in the 2h group and the 12h group(P<0.05),but the above indicators were not statistically different between the 2h group and the 12h group(P>0.05).The complications revealed no statistical differences among the three groups(P>0.05).Conclusion:PCN drainage within 12h after admission is effective in the treatment of patients with upper urinary tract calculi and infection,and it can effectively control infection and shorten hospitalization time.
作者
于建宏
张文娟
王乾龙
王磊
YU Jianhong;ZHANG Wenjuan;WANG Qianlong(The Affiliated Hospital of Gansu Medical College,Gansu Pingliang 744000,China)
出处
《河北医学》
2025年第8期1338-1343,共6页
Hebei Medicine
基金
甘肃省自然科学基金项目,(编号:25JRRL006)。
关键词
上尿路结石
经皮肾穿刺造瘘术
感染
Upper urinary tract calculi
Percutaneous nephrostomy
Infection
