ABSTRACT
Objective:To evaluate the clinical efficacy and safety of ultrasound negative pressure suction with percutaneous nephroscope in the treatment of perirenal abscess.Methods:The clinical data of 11 patients with perirenal abscess admitted to Zhejiang Provincial People's Hospital from January 2013 to February 2021 were retrospectively analyzed. There were 4 males and 7 females. The average age was 59(51-76) years. The abscess was located on the left side in 4 cases and on the right side in 7 cases. The average diameter of abscess was 11.2(8.1-19.2) cm. All patients had fever, low back pain and abdominal mass, accompanied by bladder irritation in 6 cases, gross hematuria in 5 cases, abdominal distension, nausea and anorexia in 3 cases. There were 7 cases with type 2 diabetes, 2 cases with rheumatoid arthritis and 6 cases with ipsilateral kidney and ureter stone. Among the 11 patients, 6 had a history of urinary tract infection, 1 had a history of upper respiratory tract infection, 1 had secondary infection of perirenal hematoma after traumatic renal rupture, and 3 had secondary infection of perirenal hematoma after percutaneous nephroscopy. All patients were treated with ultrasound negative pressure suction with percutaneous nephroscope under local anesthesia by single operator. The operation time, intraoperative blood loss, drainage volume, drainage tube indwelling time, postoperative body temperature returned to normal time, postoperative hospital stay, therapeutic effect and complications were analyzed.Results:All operation procedures of 11 patients were successfully completed, including 8 cases of single channel, 2 cases of double channels and 1 case of three channels. The average operation time was 44(20-74)min, the average amount of blood loss was 15(10-20)ml, the average amount of pus was 325(200-500)ml, the average indwelling time of drainage tube was 8(6-12)d, the average time of body temperature returned to normal was 0.9(0.5-2.0)d, and the average hospitalization time was 9.6(7.0-14.0)d. Before discharge, CT reexamination showed that the perirenal abscess disappeared. There were no serious complications during and after operation. The average follow-up time was 4.4(3-8) months. There was no recurrence in all patients.Conclusions:Ultrasound negative pressure suction with percutaneous nephroscope is one of the safe and effective surgical methods for the treatment of perirenal abscess. It has the advantages of small trauma, quick recovery, complete drainage, exact effect and fewer complications.
ABSTRACT
Objective To investigate the association between peripheral white blood cell (WBC) count and the carotid intimal-medial thickness (cIMT) in middle-aged and elderly Chinese of suburban area of Shanghai.Methods A total of 2 519 subjects aged 40 years or older from Jiading District,Shanghai were recruited to undergo questionnaire interview,anthropometric measurements,fasting blood sampling,and carotid B-mode ultrasonography.After excluding subjects with biochemical index missing,WBC count ＞ 10× 109/L as well as those with known myocardial infarction,cerebral infarction,coronary heart disease,and those taking lipid-lowing agents,2 239subjects were included in this analysis.Results Increased WBC count was associated with more unfavorable metabolic risk profiles.With the increasing quartiles of WBC count,cIMT were 0.558,0.570,0.573,and 0.587mm respectively(P for trend ＜ 0.01).As compared with participants in the first WBC quartile,the risks of cIMT thickening were increased by 79％,109％ in males and 29％ in females (P＞ 0.05 in females).Multiple linear regression model showed that peripheral WBC count was an independent risk marker for cIMT thickening,especially for neutrophil and monocyte count.Conclusion A high-normal WBC count was significantly associated with cIMT thickening in middle-aged and elderly Chinese of suburban area of Shanghai,especially in males.