Discussion
loss of renal function, SIRS, ureteral stones, bacterial infection, URI, pyonephrosis, septic shock, Infection, urosepsis
URI, PCT, BACTERIAL INFECTION, PYONEPHROSIS, PYONEPHROSIS, DIABETES MELLITUS, SECONDARY, SEPTIC SHOCK, INFECTION, URETERAL STONE, PATHOGENESIS, UROSEPSIS
The main finding of this study is that PCN and RUSI are effective and safe methods of emergency decompression for patients with ureteral stones and SIRS. There were no significant differences between the two groups in basic data and length of hospital stay of patients, and the time for temperature to return to normal appeared to be shorter in the PCN group, but the difference was not statistically significant. Additionally, we found patients with pyonephrosis and a higher PCT are more likely to progressed to urosepsis after early emergency drainage.Before urosepsis develops, the timing of when emergency drainage is performed is crucial; most experts agree that emergency drainage should be performed within two days of admission [PCN and RUSI are the most commonly used methods for emergency drainage, and identifying the more effective of these two methods has been controversial. A prospective, randomized study was recently performed to compare the best treatment for patients with urosepsis caused by ureteral stones. These researchers found that PCN was superior to RUSI for emergency drainage [In our study, the PCN success rate was similar to RUSI (100% vs. 96%), and PCN and RUSI are effective methods of emergency decompression for patients with ureteral stones and SIRS. Inflammatory indicators after drainage and the length of hospital stay were also compared between the two groups, and there were no statistically significant differences. The time for the temperature to return to normal seemed to be shorter in the PCN group compared to the RUSI group (2.35 ± 0.58 vs. 2.51 ± 0.62 days), but this difference was not statistically significant. For the definitive treatment, more patients in the URI group than in the PCN group chose ESWL (21 vs. 5) for their definitive treatment, and the chance of having a second surgery was significantly reduced the URI group, To the best of our knowledge, this was the first article to introduce further treatment of patients with ureteral stones and SIRS after emergency drainage. Therefore, we believe that RUSI is superior to PCN in reducing the probability of secondary surgery for patients with a lower stone load.There are many risk factors for urosepsis or septic shock. Previous studies showed that female sex, older age, diabetes mellitus, extended-spectrum ß-lactamase-producing (ESBL)-positive The nature of drainage fluid is another risk factor for patients with urosepsis. Pyonephrosis was found in 20 of 28 patients with urosepsis during primary drainage. The evolution of renal pyonephrosis has not been investigated. Obstruction caused by ureteral stones and a bacterial infection are two types of primary pathogenesis [Boeri et al. also showed that pyonephrosis can cause a rapid loss of renal function and quickly develop into urosepsis or even septic shock [Infection is another requirement. MUC and blood culture are the most commonly used methods to identify pathogens. However, some experts believe the MUC cannot be a good predictor of urosepsis because of its low positive rate [