Biến chứng nhiễm khuẩn niệu sau điều trị sỏi thận bằng phương pháp tán sỏi ngoài cơ thể

DIENDAN YHOC

BIEN CHlTNG NHIEM KHUAN NIEU

SAU OIEU TRI SOI THAN

BANG PHUaNG PHAP TAN SOI NGOAI CO THE

Tran Dinh Hung*, Tran Due**, Tran Van Hinh''

TOM TA T

Muc tieu nghien ciru: ddnh gid hien chimg nhiem khudn nieu vd mpt sd yeu id lien quun ldi nhiem

khudn nieu suu dieu Iri soi than bdng phuong phdp ldn soi ngodi ca ihi. Doi tuong va phuong phap nghien

ciru: 38 henh nhdn soi thdn dugc dieu tri hung phirong phdp tun soi ngodi cir the tir thdng 2/2009 den

thdng 12/2009 Igi khou Ngogi 2 - Binh viin Trung uong Qudn dpi 108. Sir dung phuong phdp lien cim.

Ket qua va ban luan: ludi trung hinh 47.8±7,8 ludi. kich ihudc soi trung binh 30,57±8,22mm. dien lich

be mgt soi Irung hinh 540.1±198.4mm-. sd xung Irung binh 3681.8±1170.3 xung. Tv le nhiem khudn nieu

Irudc Idn Id 5/38 BN (13.2%,). Irong do E.coli: 2'5 (40%,). Paeruginosu: 1/5 (20%,). S..saprophiticus: 2/5

(40%)). Ty le nhiim khudn nieu suu tdn lu 9/29 BN (23. 7%,). trong do gup: Ecoli 4/9 (44,4%,), P. aeruginosa

4/9 (44.4%,). Klebsiella 1/9 (11.1%,).

Til' khoa: nhiem khudn nieu, Idn soi ngodi ca the. kich thirdc soi.

I. DAT VAN DE

Tan sdi ngoai co- the (ESWL) dugc coi la

sir lya chgn hang dau trong dieu trj soi than don

gian bdi tinh hieu qua va khong xam lan. Mac dii

vay phuong phap nay cimg cb mgt so bien chirng.

mgt trong so bien chirng db la nhiem khuan nieu

(NKN) nhat la vbi nhirng sdi co kich thube Idn

can can thiep dat thong J.I trudc khi tan soi hay vdi

nhirng sdi nhiem triing.

Khi tan sdi ngoai cothe, neu cdNKN lam keo

dai thai gian nam vien, gay ton kem cho dieu trj,'

nhat la nhung truong hgp gay nhiem khuan mau,

tham chi de doa nghiem trgng tdi tinh mang BN.

Xuat phat tir thuc te db chimg toi nghien ciru de tai

nay nham mue tieu: ddnh gid biin chimg nhiem

khudn nieu ciia Idn soi ngadi co the vd tim hiiu

mpt sd yeu Id lien quun den bien chiing ndy.

'^Benh vien 5 - Qudn khu III

'^^Benh vien 108

***gc',jh vien 103 - Hgc vien Qudny

II. D6 I TI/ONG VA PHUONG PHAP

NGHIEN CUU

1. Dbi tuong nghien eiru

38 BN chan doan xac djnh sbi than cb kich

thudc > 20mm. dugc dieu trj bang phuong phap

tan sdi ngoai ca the tai BVTWQD 108 tir thang

2/2009 din thang 12/2009.

2. Phuo'ng phap nghien ciru

Sir dung phuong phap nghien cuu tien euu.

Cac BN dugc kham, lam eac xet nghiem:

- Xac djnh kich thube sbi: kich thube soi la

dudng kinh ldn nhat ciia soi tren phim X quang he

tiet nieu thang.

- Dien tich be mat sbi: dien tich be mat dugc

danh gia theo cbng thirc:

SA = Dai X Rbng x 71 x 0,25 (trong do 71 =3,14)

S6 49 (Thang 02/2010) Y HOC LA M SAN G J 45