优化抗生素的持续时间和皮肤透过的nephrostomy时间在urosepsis复杂的上部尿路结石:一个回顾性研究
Jen-Ting Hsu1, Chia-Min Lin2, Shun-Fa Hung1,3
1Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
BMC urology
|July 23, 2025
概括
最佳的抗生素持续时间和及时的泌尿排水对于管理上尿管上方结石产生的泌尿过敏至关重要. 较长的抗生素疗程和较早的干预措施可以降低尿路透镜性石 (URSL) 后的发烧和住院时间.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 尿路感染导致的危及生命的尿症 (urosepsis) 常常与尿病引起的阻塞有关.
- 由于阻塞性急性肌炎 (APN) 的次要原因,泌尿突发症的最佳管理策略仍未确定.
- 影响泌尿突发症管理的关键因素包括抗生素的时间,尿道排水的持续时间和尿路透镜性石 (URSL) 调度.
研究的目的:
- 为了研究影响尿路上部结石患者尿路结石管理的因素.
- 在URSL之前确定最佳的抗生素治疗持续时间.
- 为了确定后URSL发烧的危险因素和穿皮瘤切除术 (PCN) 时间的影响.
主要方法:
- 在107名患有尿病引起的阻塞性APN和尿液的患者进行了回顾性研究 (2013-2019).
- 患者接受了PCN排水,随后进行了URSL.
- 对人口统计,并发病,实验室结果,培养和石材特征的分析.
主要成果:
- 32%的患者经历了URSL后发烧;较长的抗生素治疗 (7.1 vs 5.7 天) 与无发烧结局相关.
- 抗生素持续时间和PCN到URSL间隔预测发烧;糖尿病是发烧的危险因素,抗生素服用>7天.
- 新出现的PCN插入导致较早的URSL和更短的住院时间.
结论:
- 在URSL之前,最佳的抗生素持续时间对于管理上尿路上方结石的尿路结石至关重要.
- 较短的抗生素疗程与URSL后发烧有关;新出现的PCN插入改善了结果.
- 糖尿病是URSL后发烧的重要预测因素.
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