Оценка результатов лечения осложнений мочекаменной болезни у больных с COVID-19
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
ВГМУ
Abstract
Цель. Изучить особенности диагностики и лечения осложнений мочекаменной болезни (МКБ) у пациентов с коронавирусной инфекцией COVID-19. Материалы и методы. В проспективном когортном исследовании оценены результаты лечения 146 пациентов. В первую группу включено 30 пациентов, пролеченных в инфекционном госпитале, с осложненным течением мочекаменной болезни и коронавирусной инфекцией COVID-19, во вторую – 116 пациентов, лечившихся в отделении урологии многопрофильной неинфекционной больницы по поводу осложнений МКБ и не инфицированных новой коронавирусной инфекцией COVID-19. Для диагностики COVID-19, у пациентов первой группы проводили ПЦР-тесты, которые были положительны в 19 (63,3%) наблюдениях, и КТ легких (при поступлении процент поражения легочной ткани варьировал от 5% до 90%). Результаты. Среди пациентов первой группы преобладали лица пожилого возраста (61±15 лет (M±сигма)), и среди них было больше женщин (66%). Характерными особенностями течения МКБ у больных с COVID-19 являются превалирование инфекционно-воспалительных осложнений (50%) и сочетание нескольких осложнений МКБ (40%). Из особенностей лечения больным первой группы в 6,6% наблюдений пришлось выполнять люмботомию с открытой нефростомией из-за распространения вторичного гнойно-деструктивного процесса на забрюшинное пространство. При оценке по шкале Clavien-Dindo частота осложнений после операций в первой группе больных составила 40%, во второй – 13,8%. Летальность в первой группе достигла 30%, во второй – 0,9%. Продолжительность стационарного лечения пациентов в первой группе составила 21 (5-39), во второй – 8 (1-56) суток. Заключение. Особенности течения и высокие цифры летальности требуют дальнейшей оптимизации лечебных подходов у пациентов с осложнениями МКБ на фоне COVID-19.
Objective. To study the peculiarities of diagnostics and treatment of urolithiasis complications among patients with new coronavirus infection COVID-19. Methods. The prospective cohort study evaluated the treatment outcomes of patients (n=146). The first group (n=30) included patients treated in infectious diseases hospital with a complicated urinary calculi disease and a new coronavirus infection COVID-19, the second group (n=116) included patients treated in the urological department of multidisciplinary non-infectious hospital due to complicated urinary tract stone disease who were not infected by new coronavirus infection COVID-19. As for COVID 19 diagnostics, patients of the first group were done PCR tests that were positive in 19 (63,3%) cases, and thoracic cavity computer tomography scanning (upon admission the percentage of pulmonary tissue involvement varied since 5% up to 90%). Results. Among the patients of the first group, elderly people prevailed (61+15 years) and there were more women among them (66%). The characteristic features of complicated urinary calculi disease in patients with COVID-19 are the prevalence of infectious and inflammatory complications (50%) and a combination of several complications of urolithiasis (40%). Among peculiarities of treatment, patients of the first group in 6.6% of cases underwent the lumbotomy with open nephrostomy, due to the spread of secondary suppurative process over the retroperitoneal space. According to the Clavien-Dindo scale, in the first group of patients the incidence of complications after surgery was 40%, in the second - 13.8%. Mortality rate in the first group reached 30%, in the second – 0.9%. The duration of hospital treatment among patients of the first group reached 21 (5-39) days, among patients of the second group – 8 (1-56) days. Conclusion. The specificity of the course associated with significant morbidity and mortality require further optimization therapeutic approaches to achieve success in patients with complications of urolithiasis during COVID-19 outbreak.
Objective. To study the peculiarities of diagnostics and treatment of urolithiasis complications among patients with new coronavirus infection COVID-19. Methods. The prospective cohort study evaluated the treatment outcomes of patients (n=146). The first group (n=30) included patients treated in infectious diseases hospital with a complicated urinary calculi disease and a new coronavirus infection COVID-19, the second group (n=116) included patients treated in the urological department of multidisciplinary non-infectious hospital due to complicated urinary tract stone disease who were not infected by new coronavirus infection COVID-19. As for COVID 19 diagnostics, patients of the first group were done PCR tests that were positive in 19 (63,3%) cases, and thoracic cavity computer tomography scanning (upon admission the percentage of pulmonary tissue involvement varied since 5% up to 90%). Results. Among the patients of the first group, elderly people prevailed (61+15 years) and there were more women among them (66%). The characteristic features of complicated urinary calculi disease in patients with COVID-19 are the prevalence of infectious and inflammatory complications (50%) and a combination of several complications of urolithiasis (40%). Among peculiarities of treatment, patients of the first group in 6.6% of cases underwent the lumbotomy with open nephrostomy, due to the spread of secondary suppurative process over the retroperitoneal space. According to the Clavien-Dindo scale, in the first group of patients the incidence of complications after surgery was 40%, in the second - 13.8%. Mortality rate in the first group reached 30%, in the second – 0.9%. The duration of hospital treatment among patients of the first group reached 21 (5-39) days, among patients of the second group – 8 (1-56) days. Conclusion. The specificity of the course associated with significant morbidity and mortality require further optimization therapeutic approaches to achieve success in patients with complications of urolithiasis during COVID-19 outbreak.
Description
КОРОНАВИРУСНЫЕ ИНФЕКЦИИ
SARS-COV-2
COVID-19
СОПУТСТВУЮЩИЕ ФАКТОРЫ (ЭПИДЕМИОЛОГИЯ)
УРОЛИТИАЗ
МОЧЕКАМЕННАЯ БОЛЕЗНЬ
ЛЮМБОТОМИЯ
МОЧЕВАЯ СИСТЕМА /ПАТОЛОГ /ХИР
МОЧЕВЫЕ ПУТИ /ПАТОЛОГ /ХИР
СМЕРТЕЛЬНЫЙ ИСХОД
ЛЕТАЛЬНЫЙ ИСХОД
ПРОСПЕКТИВНЫЕ ИССЛЕДОВАНИЯ
SARS-COV-2
COVID-19
СОПУТСТВУЮЩИЕ ФАКТОРЫ (ЭПИДЕМИОЛОГИЯ)
УРОЛИТИАЗ
МОЧЕКАМЕННАЯ БОЛЕЗНЬ
ЛЮМБОТОМИЯ
МОЧЕВАЯ СИСТЕМА /ПАТОЛОГ /ХИР
МОЧЕВЫЕ ПУТИ /ПАТОЛОГ /ХИР
СМЕРТЕЛЬНЫЙ ИСХОД
ЛЕТАЛЬНЫЙ ИСХОД
ПРОСПЕКТИВНЫЕ ИССЛЕДОВАНИЯ
Keywords
Citation
Оценка результатов лечения осложнений мочекаменной болезни у больных с COVID-19 / С. И. Панин [и др.] // Новости хирургии. - 2021. - Т. 29, № 3. - С. 318-325.