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目的探讨采用微创处理输尿管结石梗阻伴尿脓毒血症的治疗价值。方法对30例输尿管结石梗阻伴尿脓毒血症患者采取镜下逆行置双J管引流及经皮肾穿刺造瘘,至感染缓解、患者基本状况稳定1周后进行二期碎石。结果 28例患者顺利完成镜下逆行置管。失败2例经超声向导成功实施经皮肾穿刺造瘘,脓毒血症临床表现改善;至感染缓解、患者基本状况稳定1周后进行二期碎石,结石彻底清除。结论在输尿管结石梗阻伴尿脓毒血症的急诊中采取逆行置管引流及经皮肾穿造等微创治疗措施是安全有效的,辅以二期碎石术可彻底将结石清除,治疗效果可观。
Objective To investigate the value of minimally invasive ureteral calculi obstruction with uremia sepsis. Methods Thirty patients with ureteral calculi obstruction and uremia sepsis underwent microscopic retroperitoneal J-tube drainage and percutaneous nephrostomy until the infection was relieved. The patient’s basic condition was stable for one week and then the second stage gravel. Results 28 patients successfully completed retrograde microscopy. The failure of 2 cases of successful implementation of ultrasound guided percutaneous nephrostomy, clinical manifestations of sepsis improved; to infection ease, the basic stability of the patient after 1 week for two gravel, stone completely removed. Conclusions In minimally invasive treatment of ureteral obstruction with uremia sepsis, retrograde catheter drainage and percutaneous nephroureterectomy are safe and effective, and secondary lithotripsy can completely remove stones. The therapeutic effect considerable.