对于PCNL的安全性,是否需要消极的尿液培养? 从一个大体积的石头中心的经验
Xiao Bo1, Xue Zeng1, Gang Zhang1
1Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China.
Frontiers in surgery
|June 16, 2025
概括
超声指导的皮肤透气瘤切除术 (PNL) 对尿液培养和结石阳性患者是安全的. 手术前感染不会增加败血症的风险,这表明PNL是一种可行的治疗选择.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
背景情况:
- 结石通常与尿路感染并存,使治疗决策复杂化.
- 透皮石切除术 (PNL) 是一种常见的石切除手术.
- 术前尿液培养在指导PNL管理中的作用需要进一步澄清.
研究的目的:
- 评估超声导向PNL在具有阳性尿液培养的患者的安全性和结果.
- 评估手术前细菌尿的PNL患者的败血症并发症风险.
- 在PNL的背景下重新定义尿液培养结果的临床意义.
主要方法:
- 在2016年1月至2020年12月期间接受PNL的422名患者的回顾性评估.
- 患者被分为两组:阴性 (n=278) 和阳性 (n=144) 术前尿液培养.
- 所有PNL手术都使用超声波指导和标准通道接入进行.
主要成果:
- 在所有患者中都取得了成功的通道和石块碎片化.
- 与1组相比,阳性尿培养 (2组) 的患者手术前血清肌素水平较高,手术时间较长,住院时间较长.
- 组2需要更多的脏通道,并且与组1 (89.2%) 相比,直接无结石率较低 (75%).
结论:
- 超声导向PNL与标准访问显示安全和可接受的结果,即使在阳性尿液培养的患者.
- 在受控条件下,手术前感染的尿液不是PNL后严重败血症并发症的重要风险因素.
- 该研究支持在患有结石和阳性尿液培养的患者中继续使用PNL,强调谨慎管理以减轻风险.
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