关键词: 输尿管结石, 尿脓毒血症, 双J管置入术, 经皮肾穿刺造瘘术

Abstract: 【Abstract】〓Objective〓To investigate the therapeutic effect of by ureteral stent insertion (internal diversion) or percutaneous nephrostomy (external diversion) in the patients suffered from ureteral calculus complicated with urosepsis. Methods〓From Jan 2011 to Dec 2013,.a total of 63 patients suffered from ureteral calculus complicated with urosepsis were randomized into two groups. In internal diversion group, 31 patients underwent double J ureteral stenting, while in external group,.32 patients underwent percutaneous nephrostomy tube insertion. The double J stent was inserted retrograde by using cystoscope or ureteroscope,.while the percutaneous nephrostomy was done under ultrasound guidance. Results〓The overall success rate of diversion in internal diversion group and external diversion group is 96.8% and 90.6% respectively (P=0.3170). The time of controlling sepsis after the diversion were (4.6±1.9) d and (3.5±1.7) d (P=0.0184). After URL, six patients in the internal diversion group suffered from recurrent urosepsis, and no recurrence of urosepsis in external diversion group (P=0.0287). One patient progressed to septic shock among those 6 patients in the internal diversion group. Conclusion〓Both internal and external diversion appear effective in the patients suffered from ureteral calculus complicated with urosepsis,.but external diversion exists a better approach of temporary urinary diversion than internal diversion for management of ureteral calculus complicated with urosepsis.

Key words: Ureteral calculus, Urosepsis, Percutaneous nephrostomy, Double J stenting