标题：改良腔内低压灌注引流技术治疗结石梗阻性肾积脓34例

      作者：张育周，连乐林，黄志雄    普宁华侨医院泌尿外科，广东 普宁 515300

      卷次： 2020年31卷8期

      【摘要】 目的 观察改良腔内低压灌注引流技术治疗结石梗阻性肾积脓的临床疗效。方法 回顾性分析2017年9月至2019年5月在普宁华侨医院泌尿外科就诊的34例结石梗阻性肾积脓患者的临床资料，所有患者均采取改良腔内低压灌注引流技术治疗，术后根据尿培养结果给予患者抗生素治疗4 d。观察患者的治疗效果、结石清除率和并发症发生情况。结果 置入双 J管后，顺利导出大量脓絮状浑浊尿液，尿培养结果显示，大肠埃希菌 23例，金黄色葡萄球菌11例；置管24 h内，34例患者的腰部疼痛症状得到明显改善；置管48 h内，较多数患者的体温均在1 d内恢复正常，且只有2例患者出现高热症状，体温>38.5℃，但给予两联抗生素治疗后，患者的体温在2 d内恢复正常；治疗后，经泌尿系统腹部平片检查显示，34例患者中结石完全清除 30例，部分清除 3例，未完全清除 1例，清除率为97.06%；治疗后，所有患者均未出现败血症、穿孔及黏膜撕脱等并发症，仅1例患者出现出血，并发症发生率为2.94%。结论 改良腔内低压灌注引流技术治疗结石梗阻性肾积脓能有效清除患者体内结石，且手术安全性较高。
      【关键词】 结石梗阻性肾积脓；低压灌注；并发症；疗效
      【中图分类号】 R692 【文献标识码】 A 【文章编号】 1003—6350（2020）08—1032—03

Effect of modified intracavitary low-pressure perfusion and drainage in the treatment of 34 cases of calculousobstructive pyonephrosis.
ZHANG Yu-zhou, LIAN Le-lin, HUANG Zhi-xiong. Department of Urology, Puning OverseasChinese Hospital, Puning 515300, Guangdong, CHINA
【Abstract】 Objective To observe the clinical effect of modified intracavitary low-pressure perfusion and drain-age technique in the treatment of calculous obstructive pyonephrosis. Methods The clinical data of 34 patients with ob-structive pyonephrosis due to calculi treated in Department of Urology, Puning Overseas Chinese Hospital from Septem-ber 2017 to May 2019 were analyzed. All the patients were treated with improved low-pressure perfusion and drainagetechnology, and then given antibiotic treatment for 4 days according to the results of urine culture. The therapeutic effect,stone clearance rate, and complications were observed. Results After double J tube was inserted, a large number ofpus-like turbid urine was successfully exported. The results of urine culture showed that 23 cases of Escherichia coli and11 cases of Staphylococcus aureus were found. Within 24 hours after the tube was placed, the waist pain symptoms of 34patients were significantly improved; within 48 hours after the tube was placed, the body temperature of most patients re-turned to normal within 1 day, and only 2 patients had hyperthermia symptoms (with body temperature more than38.5℃ ), whose body temperature returned to normal within 2 days after applying two antibiotics. After treatment, ab-dominal plain film examination through the urinary system showed that, among 34 patients, the stone was completely re-moved in 30 cases, partially cleared 3 cases, incompletely cleared in 1 case, with the clearance rate of 97.06%. Aftertreatment, all patients had no complications such as sepsis, perforation, and mucosal avulsion, and only 1 patient devel-·短篇论著·doi:10.3969/j.issn.1003-6350.2020.08.024