输尿管导管负压吸引辅助输尿管镜碎石术治疗输尿管结石合并感染的效果

Effect of ureteral catheter negative suction assisted with ureteroscopic lithotripsy in treatment of ureteral calculus complicated with infection

摘要:

目的 探讨5 F输尿管导管负压吸引辅助6/7.5 F输尿管镜碎石术，治疗输尿管结石合并感染的安全性和有效性。方法 回顾性分析该院2020年7月－2021年12月67例采用旁置5 F输尿管导管负压吸引辅助6/7.5 F输尿管镜碎石术治疗输尿管结石合并感染的患者的临床资料，67例患者术前均有发热，入院后抗感染对症治疗，体温正常3 d后，行输尿管镜碎石治疗。术中输尿管镜下留置5 F输尿管导管并越过结石上方，输尿管导管末端连接负压吸引，并在输尿管镜下应用200 μm钬激光碎石。结果 术后6例患者出现发热。其中，低热（< 38.5℃）4例，高热（38.9℃和39.4℃）2例，术后感染率为9.0%，术后2～4周拔除输尿管双J管，术后清石率为83.6%。所有病例均未发生输尿管穿孔、黏膜撕脱和感染性休克等严重并发症。结论 5 F输尿管导管负压吸引辅助6/7.5 F输尿管镜碎石术治疗输尿管结石合并感染，安全、有效，可操作性强，可降低术后感染和尿脓毒血症的发生率。

Abstract:

Objective To investigate the safety and efficacy of 5 F ureteral catheter negative suction assisted with 6/7.5 F ureteroscopic lithotripsy in treatment of ureteral calculus complicated with infection.Methods 67 patients with ureteral calculus complicated with infection were treated by 5 F ureteral catheter negative suction assisted with 6/7.5 F ureteroscopic lithotripsy from July 2020 to December 2021, all the patients had fever before operation. 5 F ureteral catheter was indwelled under the ureteroscope and passed over the stone during the operation, the end of the ureteral catheter was connected to negative pressure suction, 200 μm holmium laser was used to crush the calculus under negative pressure suction.Results There were 6 patients had fever after operation, including 4 cases of low fever ( < 38.5℃) and 2 cases of high fever (38.9℃ and 39.4℃). The postoperative infection rate was 9.0%. The ureteral double J stent was removed 2 to 4 weeks after operation. The postoperative stone clearance rate was 83.6%; All cases had no serious complications such as ureteral perforation, mucosal avulsion, and septic shock.Conclusion 5 F ureteral catheter negative suction assisted with 6/7.5 F ureteroscopic lithotripsy is safe and effective in the treatment of ureteral calculus complicated with infection, it can reduce the occurrence of postoperative infection and urosepsis.