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肾结石疾病输尿管镜检查成功可使尿路感染得到缓解:12个月随访的前瞻性结果

Successful ureteroscopy for kidney stone disease leads to resolution of urinary tract infections: Prospective outcomes with a 12-month follow-up.

作者信息

Oliver Rachel, Ghosh Anngona, Geraghty Robert, Moore Sacha, Somani Bhaskar K

机构信息

University Hospital Southampton NHS Trust, Southampton, United Kingdom.

出版信息

Cent European J Urol. 2017;70(4):418-423. doi: 10.5173/ceju.2017.1549. Epub 2017 Nov 7.

Abstract

INTRODUCTION

To investigate the resolution of urinary tract infection (UTI) with the successful treatment of kidney stone disease (KSD).We reviewed the outcomes of ureteroscopy (URS) and stone treatment for patients with positive urine culture or recurrent UTIs and evaluated whether the infection resolved with the clearance of their urinary stones.

MATERIAL AND METHODS

Between March 2012 and July 2016, consecutive patients who underwent URS for stone disease with a history of recurrent UTIs or culture proven UTIs were identified from a prospective database. Data was recorded on stone free rate (SFR) and infection free rate (IFR) during the follow-up period at 3, 6 and 12-months.

RESULTS

During the study period, 103 consecutive patients with stone disease and associated UTI underwent URS over a 52-month period (mean age: 60 years, Female: Male ratio of 2:1). The mean cumulative stone size was 16 mm (range: 3-107 mm) and a positive pre-operative urine culture was found in 81 (79%) patients. While the overall SFR was 96%, the total complication rate was 12.6% (n = 13) and these were all Clavien I/II complications.At follow-up, the SFR and IFR was 96% and 88% at 3-months, and 82% and 71% at 12-months, respectively (p <0.001). While almost three-quarters of patients were stone and infection free at 12-months, the majority of those with stones recurrence also had recurrence of their UTI.

CONCLUSIONS

The majority of patients will remain infection free at the 12-month follow-up if they are stone free after their initial treatment. Stone recurrence, which is more likely in high-risk patients, is also linked to the recurrence of their UTI.

摘要

引言

为了研究肾结石病(KSD)成功治疗后尿路感染(UTI)的缓解情况。我们回顾了输尿管镜检查(URS)及对尿培养阳性或复发性UTI患者的结石治疗结果,并评估了随着尿路结石清除感染是否得到缓解。

材料与方法

在2012年3月至2016年7月期间,从前瞻性数据库中识别出因结石病接受URS且有复发性UTI病史或经培养证实为UTI的连续患者。记录随访期3个月、6个月和12个月时的无结石率(SFR)和无感染率(IFR)。

结果

在研究期间,103例因结石病合并UTI的连续患者在52个月内接受了URS(平均年龄:60岁,女性与男性比例为2:1)。平均累积结石大小为16毫米(范围:3 - 107毫米),81例(79%)患者术前尿培养呈阳性。总体SFR为96%,总并发症发生率为12.6%(n = 13),均为Clavien I/II级并发症。随访时,3个月时SFR和IFR分别为96%和88%,12个月时分别为82%和71%(p <0.001)。虽然近四分之三的患者在12个月时无结石且无感染,但大多数结石复发的患者也有UTI复发。

结论

如果大多数患者在初始治疗后无结石,那么在12个月随访时将保持无感染状态。高风险患者更易出现结石复发,这也与UTI复发有关。

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