Abstract:

Objective　To investigate the overall nursing for patients with medullary sponge kidney stone complicated with infection undergoing percutaneous nephrolithotomy (PCNL). Methods　A total of 20 patients with medullary sponge kidney stone complicated with infection admitted to Urinary Surgery, The Fifth Affiliated Hospital of Guangzhou Medical University from December 2018 to December 2020 were included in the study, including 12 males and 8 females, aged 12-68 years. Preoperative evaluation and health education, nursing psychological intervention, dietary guidance, postoperative observation on patients' conditions and drainage fluid, and adjusting the diet plan were performed on these patients. Results　All the 20 patients got infection control, with normal white blood cell count, no bacteria found in urine culture, and the creatinine level recovered to 58-312 µmol/L, uric acid 320-498 µmol/L. The vital signs returned to normal 2 days later in 3 patients with septic shock, and the urine color turned clear 5 days later in 1 patient with hematuria. The stone clearance rate reached to 90%, and the patients were improved and discharged. Conclusions　Sponge kidney patients concurrent with kidney stone or infection are common. Rational use of antibiotics, prevention of complications, patient psychological intervention, and overall specialized nursing intervention are conducive to the patients' early recovery.

Key words:

Medullary sponge kidney, Kidney stone, Infection, Percutaneous nephrolithotomy, Nursing intervention

摘要：

目的　探讨髓质海绵肾肾结石合并感染患者行经皮肾镜取石术的整体护理。方法　统计广州医科大学附属第五医院泌尿外科2018年12月至2020年12月收治的20例髓质海绵肾肾结石合并感染患者作为研究对象，其中男12例，女8例，年龄12～68岁。进行术前的评估和健康宣教、护理心理干预、饮食指导，术后严密观察病情、引流液的情况，调整饮食计划。结果　20例患者感染控制，血白细胞正常，尿培养未见有细菌，肌酐恢复到58～312 µmol/L，尿酸320～498 µmol/L，3例感染性休克患者2 d后生命体征恢复正常，1例血尿患者5 d后尿液颜色转清，结石清除率达到90%，患者好转出院。结论　海绵肾易并发结石或感染，合理使用抗生素，防止并发症发生，耐心心理干预和整体专科护理干预有助于患者早日康复。

关键词:

髓质海绵肾, 肾结石, 感染, 经皮肾镜取石术, 护理干预