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目的:探讨负压吸引是否可减少脓肾患者二期经皮肾镜取石术(PCNL)后发热的发生。方法:2012年1月~2013年12月期间,将合并脓肾的44例上尿路结石患者,先造瘘引流脓液并使用敏感抗生素或经验性使用抗生素后,行二期PCNL,按结石的最大直径及结石的类型前瞻性将患者随机分为负压吸引组22例和常规组22例,对比两组患者术中术后尿源性脓毒症的发生率、术后发热的发生率、手术时间、结石清除率。结果:负压吸引组术中术后无患者发生尿源性脓毒症,术后发热1例,平均手术时间为(51.09±30.12)(15~112)min,结石清除率为86.4%(19/22);常规组术后发生尿源性脓毒症2例,另有5例患者术后发热,平均手术时间为(66.64±35.83)(18~127)min,结石清除率为59.1%(13/22)。两组间发热的发生率(P=0.045)、结石清除率(P=0.044)差异有统计学意义,脓毒症的发生率(P=0.488)、手术平均时间(P=0.127)差异无统计学意义。结论:负压吸引可以减少脓肾患者二期PCNL后发热的发生,并提高结石清除率。
Objective: To investigate whether negative pressure can reduce the incidence of pyrexia after percutaneous nephrolithotomy (PCNL) in patients with pus. Methods: From January 2012 to December 2013, 44 patients with upper urinary tract stones with purulent kidney were treated with fistula drainage pus and sensitive antibiotics or empirical antibiotics. Of the maximum diameter and type of stone prospectively patients were randomly divided into 22 cases of negative pressure suction group and 22 cases of conventional group, compared two groups of patients postoperative urinary sepsis incidence, the incidence of postoperative fever , Operation time, stone clearance rate. Results: There was no postoperative urinary sepsis in the negative suction group. One patient had postoperative fever, the average operation time was (51.09 ± 30.12) (15 ~ 112) min and the stone clearance rate was 86.4% (19 / 22). In the routine group, 2 cases of urinary sepsis occurred after operation, and 5 cases had fever after operation. The average operation time was (66.64 ± 35.83) (18 ~ 127) min and the stone removal rate was 59.1% 13/22). The incidence of fever (P = 0.045) and stone clearance (P = 0.044) between the two groups were statistically significant, the incidence of sepsis (P = 0.488), the average operation time (P = 0.127) Significance of learning. Conclusion: Negative pressure suction can reduce the occurrence of post-PCNL fever in pus kidney patients and improve the stone clearance rate.