@article{oai:redcross.repo.nii.ac.jp:00013772,
 author = {小島, 圭太郎 and 亀山, 紘司 and 上田, 秀親 and 柚原, 一哉},
 journal = {高山赤十字病院紀要, Japanese Red Cross Takayama Hospital},
 month = {Mar},
 note = {2015年１月より2017年10月までに、尿管結石を起因とした閉塞性尿路感染にて当院を
受診した53例につき臨床検討を行った。平均年齢71.2歳、男女比41：12であった。主訴は発熱22
例、併存症として、高血圧を22例、糖尿病を4例に認めた。ドレナージ法は、腎瘻造設１例、尿
管ステント留置52例であった。12例がICUにて初期治療を行った。初期の使用抗菌薬は、MEPM
33例。培養結果は、E.coli 28例であった。結石は、左34例、右19例、上部尿管38例、平均長径
8.63mmであった。尿路敗血症を、27例に認めた。入院治療中に６例の合併症を認めたが、後遺
障害なく軽快し全例感染症治癒し退院している。感染症軽快後の結石治療については、ESWL ７
例、TUL 27例であった。, Fifty-three patients (12 females, 41 males; mean age, 71.2 years) required emergent urinary
drainage by percutaneous nephrostomy or ureteral stenting for treatment of acute obstructive
urinary infection with ureteral calculi from January in 2015 to October in 2017. Symptom onset
began with fever in 22 patients. Of the 53 patients, 4 also had diabetes mellitus and 22 had
hypertension. Fifty-two of 53 patients were managed by ureteral stenting. All patients had
hydronephrosis. Twelve patients required admission to the intensive care unit (ICU). Thirty-three
patients initially were empirically treated with meropenem (MEPM). Escherichia coli (E.coli) was
the causative agent in 28 episodes. Thirty-four cases of the calculi were located on the left side,
and 19 were on the right side. The calculi were located in the upper ureter in 38 events. The
mean stone size was 8.63 mm. In 27 events, the criteria for sepsis were fulfilled. Nineteen and 13
patients met the criteria for having septic shock and disseminated intravascular coagulation (DIC),
respectively. There were 6 complications, but all patients were cured. For operative procedure
after recovery, extracorporeal shock wave lithotripsy (ESWL) was performed in 7 patients, whereas
transurethral ureterolithotripsy (TUL) was performed in 27 patients.},
 pages = {24--29},
 title = {尿管結石を起因とした閉塞性尿路感染に対する緊急ドレナージ 施行例の臨床的検討},
 volume = {41},
 year = {2018}
}