Department of Urology, Shanghai First People's Hospital Affiliated to Shanghai Jiaotong University, No. 650 Xinsongjiang Road, Songjiang district, Shanghai, 201620, China.
Urology Department, Weifang Yidu Central Hospital, Qinzhou, 262509, Shandong, China.
Urolithiasis. 2017 Dec;45(6):579-583. doi: 10.1007/s00240-017-0964-3. Epub 2017 Feb 22.
Ureteric stenting is an effective drainage method in patients with acute urinary tract infection caused by ureteral calculi; however, the optimal ureteral stent indwelling time has not been clearly defined. The aim of this study was to evaluate the effect of ureteric stent indwelling time on the treatment of acute infection secondary to urinary tract calculi. A total of 142 patients with acute infection caused by urinary tract calculi were identified retrospectively from January 2011 to August 2015 at our institution. 63 patients were with ureteric stenting for 7 days (A group) and 79 patients with ureteric stenting for more than 7 days (B group). The patient characteristics of two groups were analyzed and the clinical data before and after stenting were compared. The postoperative complication outcomes were collected and analyzed. Effective drainage obtained from ureteral stenting clearly abated the infection after stenting for 7 days; WBC count, WBCs in urine, and positive rate of urine culture were significantly decreased compared with the condition of immediate stenting. Both groups showed similar stone clearance rates (96.8% vs. 96.2%, p = 0.841), and there was no significant difference in the rate of postoperative complications, especially related to urinary tract infection (6.3% vs. 6.3%, p = 1.000). It is safe and effective for patients with acute urinary tract infection secondary to urinary tract calculi to be treated by ureteroscopic lithotripsy after stenting for one week. Prolonging the stenting period achieves no added benefit for patients.
输尿管支架置入术是治疗输尿管结石引起的急性尿路感染的有效引流方法；然而，输尿管支架留置的最佳时间尚未明确。本研究旨在评估输尿管支架留置时间对治疗尿路结石继发急性感染的影响。本研究回顾性分析了 2011 年 1 月至 2015 年 8 月在我院因尿路结石导致急性感染的 142 例患者。63 例患者行输尿管支架置入术 7 天（A 组），79 例患者行输尿管支架置入术超过 7 天（B 组）。分析两组患者的一般资料，并比较支架置入前后的临床资料。收集并分析术后并发症发生情况。输尿管支架置入术后有效引流可明显缓解感染，支架置入 7 天后白细胞计数、尿白细胞计数及尿培养阳性率均明显下降。两组结石清除率相似（96.8%比 96.2%，p=0.841），术后并发症发生率，特别是与尿路感染相关的并发症发生率无显著差异（6.3%比 6.3%，p=1.000）。对于因尿路结石继发急性尿路感染的患者，行输尿管镜碎石术后支架置入 1 周是安全有效的。延长支架留置时间对患者没有额外获益。
