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目的探讨微创治疗在输尿管结石梗阻并尿脓毒血症中的应用价值。方法对28例输尿管结石梗阻合并尿脓毒血症患者急诊行输尿管镜直视下逆行置管引流术和经皮肾穿刺造瘘术,待感染控制、患者一般情况稳定7 d后行二期碎石术。结果输尿管镜直视下逆行置双J管成功24例。失败4例在超声引导下成功行经皮肾穿刺造瘘术,脓毒血症症状得到控制;待感染控制、患者一般情况稳定7 d后二期碎石手术,结石清除完全。结论输尿管镜直视下逆行置管引流术和经皮肾穿刺造瘘术是急诊处理输尿管结石梗阻合并尿脓毒血症安全有效的微创治疗方法,联合二期碎石术能完整清除结石,临床效果满意。
Objective To explore the value of minimally invasive treatment in ureteral obstruction and urinary sepsis. Methods 28 cases of ureteral obstruction combined with urinary sepsis patients underwent retrograde ureteroscopic retrograde catheter drainage and percutaneous nephroureterectomy until the infection was controlled. The patients were generally stable for 7 days and then the second stage Stone surgery. Results ureteroscopic retrograde retrograde placement of double J tube successfully 24 cases. The failure of 4 cases under the guidance of ultrasound in the successful percutaneous nephrostomy, sepsis symptoms were controlled; to be infection control, the patient is generally stable for 7 days after the two lithotripsy, stones completely cleared. Conclusion retrograde catheter drainage under ureteroscopy and percutaneous nephrostomy is an effective and safe minimally invasive treatment of ureteral calculi obstruction combined with urinary sepsis. Combined with the second stage lithotripsy can completely remove stones, Satisfactory clinical results.