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复杂尿路感染中的经皮肾造瘘术

Percutaneous Nephrostomy in Complicated Urinary Tract Infections.

作者信息

Mondal Utsav, Viswanathan Stalin, Sreenivasan Kodakkattil Sreerag

机构信息

General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND.

Urology and Renal Transplantation, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND.

出版信息

Cureus. 2022 Jul 9;14(7):e26682. doi: 10.7759/cureus.26682. eCollection 2022 Jul.

Abstract

Background The study aimed to determine the various indications for percutaneous nephrostomy (PCN) primarily in patients with a urinary tract infection and to determine the various complications arising in these patients due to the procedure. Materials and methods A retrospective study of five-year data based on registers of the Department of Urology was performed. Among 716 patients, 226 inpatient data were obtained, curated, and analyzed. Indications for PCN, the periprocedural complications, the PCN's duration, details of antibiotics, risk factors for UTI, development of acute kidney injury, and renal replacement therapy were recorded. Results Patients were mostly female (53.1%, n=120/226). Malignancy (n=109, carcinoma cervix=68/109) and nephrolithiasis (n=70) contributed to 79.2%. Infections such as pyelonephritis, renal abscess, perinephric abscess, and genitourinary tuberculosis were identified in 47. Infectious diseases were significantly associated with younger age, female gender, diabetes, and prior pyelonephritis. PCN was placed at a median of two days after admission, and bilateral PCN was placed in 36 (15.2%) patients. Hydroureteronephrosis (probably infected) was an indication for PCN in 164/226 patients. In 33 patients with an infectious disease, PCN was performed for an obstructed urinary system. One major and two minor complications gave a rate of 0.06% for patients with infections, which was less than the accepted threshold of 4%. Conclusions We intended to study the utility and problems with placing a PCN catheter in patients with complicated urinary infections. We conclude that PCN is a safe and effective procedure in urinary tract infections with obstructed drainage.

摘要

背景 本研究旨在确定经皮肾造瘘术(PCN)主要在尿路感染患者中的各种适应证,并确定该手术在这些患者中引发的各种并发症。材料与方法 基于泌尿外科的登记资料进行了一项为期五年的数据回顾性研究。在716例患者中,获取、整理并分析了226例住院患者的数据。记录了PCN的适应证、围手术期并发症、PCN持续时间、抗生素详情、UTI的危险因素、急性肾损伤的发生情况以及肾脏替代治疗情况。结果 患者大多为女性(53.1%,n = 120/226)。恶性肿瘤(n = 109,宫颈癌 = 68/109)和肾结石(n = 70)占79.2%。在47例患者中发现了肾盂肾炎、肾脓肿、肾周脓肿和泌尿生殖系统结核等感染。传染病与年轻、女性、糖尿病和既往肾盂肾炎显著相关。PCN在入院后中位时间为两天放置,36例(15.2%)患者接受了双侧PCN。输尿管肾积水(可能感染)是226例患者中164例进行PCN的适应证。在33例患有传染病的患者中,因泌尿系统梗阻而进行了PCN。1例严重并发症和2例轻微并发症,感染患者的发生率为0.06%,低于公认的4%阈值。结论 我们旨在研究在复杂尿路感染患者中放置PCN导管的效用和问题。我们得出结论,在引流受阻的尿路感染中,PCN是一种安全有效的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b56a/9358986/5ae87d67fcac/cureus-0014-00000026682-i01.jpg

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