输尿管结石并发感染的诊断与治疗研究现状及展望

Current Research Status and Future Prospects in the Diagnosis and Treatment of Ureteral Stones Complicated by Infection

摘要: 输尿管结石作为泌尿系统常见急腹症，其发病率近年来持续攀升。该病症多合并感染，不仅发病率高，还可能引发脓毒症和肾功能损害等严重并发症，因此临床及时诊断和有效治疗显得尤为重要。得益于医学影像技术和微生物学检测手段的进步，诊断准确率已显著提升，但关于感染与结石相互作用的机制仍需进一步研究。目前研究重点集中在两方面：一是优化抗生素治疗方案以覆盖常见病原体，二是探讨输尿管镜取石或经皮肾造瘘等手术干预的最佳时机，以期在感染控制和结石清除之间取得平衡。然而临床实践仍面临诸多挑战，包括日益严峻的抗生素耐药问题，以及手术时机与方式选择等个体化治疗策略的缺乏。本综述将系统梳理该领域的流行病学特征、病理生理机制、诊断与治疗进展，剖析现有管理策略的不足，并为未来研究方向提出建议，从而为改善患者预后提供参考。

Abstract: Ureteral stones, a common acute abdominal condition of the urinary system, have seen a continuous rise in incidence in recent years. This condition is frequently complicated by infection, which not only exhibits a high incidence rate but may also lead to severe complications, such as sepsis and renal impairment. Therefore, timely diagnosis and effective treatment are of paramount importance in clinical practice. Thanks to advancements in medical imaging technology and microbiological detection methods, diagnostic accuracy has significantly improved. However, further research is needed to elucidate the mechanisms underlying the interaction between infection and stones. Current research efforts primarily focus on two aspects: optimizing antibiotic treatment regimens to cover common pathogens and determining the optimal timing for surgical interventions, such as ureteroscopic stone extraction or percutaneous nephrostomy, aiming to balance infection control and stone clearance. Nevertheless, clinical practice still faces numerous challenges, including the increasingly severe issue of antibiotic resistance and the lack of individualized treatment strategies regarding the timing and selection of surgical approaches. This review systematically examines the epidemiological characteristics, pathophysiological mechanisms, and advancements in the diagnosis and treatment of this field, analyzes the shortcomings of existing management strategies, and proposes directions for future research to provide insights for improving patient prognosis.