中心静脉导管行经皮肾穿刺引流在上尿路结石合并脓毒血症中的应用研究

Utilizing central venous catheter for percutaneous nephrostomy in upper urinary calculi complicated with sepsis

摘要:

目的：评价中心静脉导管行经皮肾穿刺引流在上尿路结石合并脓毒血症中的临床效果。方法：选择单侧上尿路结石合并尿脓毒血症患者50例，随机分为2组，每组25例，实验组采用中心静脉导管行经皮肾穿刺引流术，对照组行传统经皮肾造瘘术。比较2组手术时间、术中出血量、穿刺成功率、并发症率、引流管阻塞率。结果：2组均成功手术解除上尿路梗阻，未出现造瘘管脱落。试验组和对照组手术时间分别为（25.10±4.05） min和（30.70±6.59） min，差异有统计学意义（P=0.001）；术中出血量分别为（10.30±5.01） mL和（15.20±4.24） mL，差异有统计学意义（P=0.001）；穿刺成功率分别为100%和96%，差异无统计学意义（P=0.312）；并发症发生率分别为4%和12%，差异无统计学意义（P=0.297）；引流管阻塞发生率分别为4%和0%，差异无统计学意义（P=0.312）。结论：中心静脉导管行经皮肾穿刺引流可成为治疗上尿路结石合并脓毒血症的安全、有效方法。

Abstract:

Objective：To evaluate the clinical effect of central venous catheter for percutaneous nephrostomy in upper urinary calculi complicated with sepsis. Methods：Fifty patients with complications of unilateral upper urinary calculi and urinary sepsis were randomly divided into two groups，with 25 in each group. The percutaneous nephrostomy via central venous catheter was performed in the experimental group，while the traditional percutaneous nephrostomy was performed in the control group. Operation time，tran－soperative blood loss，puncture success rate，complication rate，and drainage tube obstruction rate were compared between two groups. Results：Upper urinary obstruction was successfully relieved in two groups，without fistula falling. Operation time in the experimental group and the control group were（25.10±4.05） min and（30.70±6.59） min，respectively（P=0.001）；transoperative blood loss were（10.30±5.01） mL and（15.20±4.24） mL，respectively（P=0.001）；success rate of puncture were 100% and 96%，respectively，without statistically significant difference. Complication rate were 4% and 12%，respectively，without statistically significant difference（P=0.297）. Drainage tube obstruction rate were 4% and 0%，respectively，without statistically significant difference（P=0.312）. Conclusion：Percutaneous nephrostomy via central venous catheter can be a safe and effective method for the treatment of upper urinary calculi complicated with sepsis.