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目的探讨输尿管软镜在肾结石合并复杂尿路感染治疗中的应用价值。方法选取2015年8月至2016年8月住院治疗的肾结石合并复杂尿路感染患者120例作为研究对象,采取随机数字表将其分成两组,每组60例。观察组给予输尿管软镜碎石术治疗,对照组给予经皮肾镜碎石术治疗,比较两组手术疗效、感染缓解情况及T淋巴细胞亚群变化情况。结果观察组手术时间明显长于对照组,但术中出血量、住院时间、并发症发生率均明显低于对照组(P<0.05,P<0.01),两组结石清除率比较无统计学差异(P>0.05);观察组感染缓解率为81.67%,对照组为78.33%,两组感染缓解率比较差异无统计学意义(P>0.05);观察组手术前后T淋巴细胞亚群无明显改变(P>0.05);对照组术毕1 h、术后24 h CD3+、CD4+、CD4+/CD8+均较术前有明显下降(P<0.05,P<0.01),但术后72 h均恢复至术前水平。结论敏感抗生素保护下行输尿管软镜碎石术治疗肾结石合并复杂尿路感染相对于经皮肾镜碎石术在结石清除率方面效果相当,但输尿管软镜碎石术对机体创伤更小、并发症更少。
Objective To investigate the value of ureteroscopy in the treatment of complicated urinary tract infection with nephrolithiasis. Methods A total of 120 inpatients with nephrolithiasis complicated with urinary tract infection hospitalized in our hospital from August 2015 to August 2016 were selected as the study subjects. They were divided into two groups according to a random number table, with 60 cases in each group. The observation group was given ureteroscopic lithotripsy and the control group was treated with percutaneous nephrolithotomy. The curative effect, infection relief and T lymphocyte subsets in the two groups were compared. Results The operation time of the observation group was significantly longer than that of the control group, but the intraoperative blood loss, hospital stay and complication rates were significantly lower than those of the control group (P <0.05, P <0.01). There was no significant difference between the two groups (P> 0.05). The response rate of observation group was 81.67% and that of control group was 78.33%, there was no significant difference between the two groups (P> 0.05) .There was no significant change of T lymphocyte subsets in the observation group before and after operation (P <0.05, P <0.05). In the control group, the levels of CD3 +, CD4 + and CD4 + / CD8 + decreased significantly at 1 h after operation and at 24 h after operation Level. Conclusions Sensitive antibiotics protect ureteral calculi with complex urethral lithotripsy in the treatment of nephrolithiasis complicated with urinary tract infection is quite effective in the stone clearance rate, but the ureteroscopic soft lithotripsy is less invasive on the body and complicated by Less disease.