目的评价无管化经皮肾镜取石术(PCNL)治疗大肠埃希菌(E.大肠杆菌)菌尿。我们对84例接受PCNL的大肠杆菌菌尿症患者进行了回顾性分析。根据手术结束时是否放置了肾造瘘管,将患者分为两组。术前临床资料,手术结果,并对术后并发症进行比较。然后,对大肠埃希菌尿患者PCNL成功率预测因素进行回归分析。PCNL后,残余碎片≤4毫米被认为是成功的。在基线,两组在年龄方面相似,性别,BMI,潜在的疾病,肾积水,石材特性,和尿液分析。无管化PCNL组术后发热1例(3.8%),常规PCNL组5例(8.6%)(p>0.05)。成功率没有显着差异,血红蛋白减少,疼痛评分,输血,和住院费用。然而,无管PCNL组手术时间明显缩短(60vs.70分钟,p=0.033),导管留置时间(2vs.4天,p<0.001),和住院时间(3vs.5天,p<0.001)比常规PCNL组。在预测成功的因素分析中,石头直径,石头负担,手术时间与PCNL成功率相关。对大肠杆菌菌尿患者进行无管化PCNL是安全有效的。与传统的PCNL相比,无管PCNL可加速患者康复并缩短住院时间。
To evaluate the safety and efficacy of
tubeless percutaneous nephrolithotomy (PCNL) in patients with Escherichia coli (E. coli) bacteriuria. We conducted a retrospective review of 84 patients with E. coli bacteriuria who underwent PCNL. Patients were divided into two groups according to whether a nephrostomy tube is placed at the end of the procedure. Preoperative clinical data, surgical outcomes, and postoperative complications were compared. Then, regression analysis of factors predicting success rate of PCNL in patients with E. coli bacteriuria was performed. After PCNL, residual fragments ≤ 4 mm were considered as success. At baseline, the two groups were similar with regard to age, gender, BMI, underlying disease, hydronephrosis, stone characteristics, and urinalysis. Postoperative fever occurred in 1 patient (3.8%) in the
tubeless PCNL group, and in 5 patients (8.6%) in the conventional PCNL group (p > 0.05). There were no significant differences in terms of successful rate, decrease in hemoglobin, pain scores, blood transfusion, and hospitalization expenses. However, the
tubeless PCNL group had significantly shorter operative time (60 vs. 70 min, p = 0.033), indwelling time of catheter (2 vs. 4 days, p < 0.001), and hospital stays (3 vs. 5 days, p < 0.001) than the conventional PCNL group. In the analysis of factors predicting success, the stone diameter, stone burden, and operative time were associated with success rate of PCNL. It is safe and effective to perform
tubeless PCNL in patients with E. coli bacteriuria. Compared to conventional PCNL,
tubeless PCNL accelerates patient recovery and shortens hospital stays.