ОСТРЫЙ ГНОЙНЫЙ ПИЕЛОНЕФРИТ (ОБЗОР ЛИТЕРАТУРЫ). ЧАСТЬ I – ДИАГНОСТИКА
Аннотация
Диагноз острого пиелонефрита основывается на клинико-лабораторном синдроме: боли в поясничной области, повышение температуры тела до 38°С и выше с ознобами; у части пациентов отмечается дизурия; лейкоцитоз со сдвигом формулы белой крови влево, повышение скорости оседания эритроцитов, повышение С-реактивного белка и фибриногена, лейкоцитурия и бактериурия. Синдром одинаков при остром серозном пиелонефрите и при гнойных формах острого пиелонефрита. Для исключения или подтверждения таких форм, как: карбункул и абсцесс почки, эмфизематозный пиелонефрит, некроз почечных сосочков, пионефроз, используются ультразвуковое исследование с допплерографией и компьютерная томография с контрастным усилением, что позволяет выявить у пациентов ряд абсолютных признаков очагового гнойного поражения паренхимы почки. Выявление в почках у пациентов с острым пиелонефритом изменений в виде вероятных эхоскопических и томогорафических признаков требует выполнения ряда лабораторных исследований: С-реактивный белок, содержание пресепсина и прокальцитонина в крови, иммунограмма. Превышение пороговых значений этих показателей при наличии у пациентов вероятных эхоскопических и томографических признаков оправдывает диагноз острого гнойного пиелонефрита. От результатов использования методов визуализации почек и специальных лабораторных методов исследования зависит составление адекватного плана лечения пациентов с острым пиелонефритом.
Литература
Kapustin SV, Ouen R, Pimanov SI. Ultrazvukovoe issledovanie v urologii i nefrologii. Moskva: Umnyj doctor; 2017. 175 p. (Russian).
Apolikhin ОI, Kakorina EP, Sivkov AV, Beshliev DA, Solntseva TV, Komarova VA. Official statistics on urological morbidity in the Russian Federation. Urologiia. 2008;3:3-9. edn: JSCXNT. (Russian).
Beshliev DA, Hodyreva LA. Diagnostika i lechenie ostrogo pielonefrita. Trudnyj pacient. 2007;5(12-13):5-8. edn: OEZMVX. (Russian).
Antonov AV. Liquid tumors of the retroperitoneum: diagnosis and treatment. Urology Reports. 2012;2(4):32-41. edn:PZHQKB.
Goncharova YM, Kuzmenko VV, Kuzmenko AV. Promising directions in the treatment of acute pyelonephritis (literature review). Journal of new medical technologies. 2012;19(2):291-296. edn: PBGKBB. (Russian).
Alferov SM, Grishin MA, Durnikin AM, Revkovskaya NS. Gnojno-destruktivnye formy pielonefrita, oslozhnennye urosepsisom i ostroj pochechnoj nedostatochnostju. Urology Reports. 2016;6(S):9-10. edn: WDINSF. (Russian).
Sinyakova LA, Bernikov EV, Loran OB. Kidneys functional state in patients suffered purulent pyelonephritis. Urology Herald. 2018;6(4):49-59. https://doi.org/10.21886/2308-6424-2018-6-4-49-59. https://elibrary.ru/yxcrch. (Russian).
Kurzanceva OM. Sovremennaja luchevaja diagnostika abscessa pochki. SonoAce Ultrasound. 2018;31:47-56. (Russian).
Pytel JuA, Zolotarev II. Neotlozhnaja urologija. Moskva: Medicina; 1985. 317 p. (Russian).
Ljulko AA, Udovickij JuI, Kadiri TR, Barannik SI, Stus VP, Lysyk OS, Molchanov RN, Fridberg AM, Agafonov NV, Ljulko AV. Neotlozhnaja urologija i nefrologija. Kiev: Zdorovja; 1996. 285 p. (Russian).
Komyakov BK, Novikov AI, Zamyatnin SA, Yalfimov IS. Acute infectious diseases of the kidney and urinary bladder: effectiveness of management. Urologiia. 2010;5:3-6. edn: MVOFTN. (Russian).
Nechiporenko NA, Nechiporenko AN. Neotlozhnye sostojanija v urologii. Minsk: Vyshjejshaja shkola; 2012. 400 p. edn: RXHDKT. (Russian).
Kogan MI, Naboka YuL, Gudima IA, Gazaev ZI, Ibishev KhS, Mitusova EV. New view on etiological structure of the acute obstructive pyelonephritis. Modern problems of science and education. 2012;4:68. edn: PBIPYL. (Russian).
Takhar SS, Moran GJ. Diagnosis and management of urinary tract infection in the emergency department and outpatient settings. Infect Dis Clin North Am. 2014;28(1):33-48. https://doi.org/10.1016/j.idc.2013.10.003.
Fasugba O, Gardner A, Mitchell BG, Mnatzaganian G. Ciprofloxacin resistance in community- and hospital-acquired Escherichia coli urinary tract infections: a systematic review and meta-analysis of observational studies. BMC Infect Dis. 2015;15:545. https://doi.org/10.1186/s12879-015-1282-4.
Hudepohl NJ, Cunha CB, Mermel LA. Antibiotic Prescribing for Urinary Tract Infections in the Emergency Department Based on Local Antibiotic Resistance Patterns: Implications for Antimicrobial Stewardship. Infect Control Hosp Epidemiol. 2016;37(3):359-360. https://doi.org/10.1017/ice.2015.283.
Grigorev NA, Zaitsev AV, Kharchilava RR. Acute pyelonephritis. Urologiia. 2017;1(Suppl):19-26. edn: YIAUTX. (Russian).
Uchvatkin GV, Gajvoronskij EA. Urosepsis - aktualnaja problema sovremennoj urologii. Urology Reports. 2017;7(Suppl):115-116. edn: YQAAYP. (Russian).
Naboka YuL, Kogan MI, Gudima IA, Mitusova EV, Bedzhanyan SK, Chernitskaya ML. Long-term monitoring of leukocyturia and bacteriuria after acute obstructive pyelonephritis. Urologiia. 2018;4:44-48. https://doi.org/10.18565/urology.2018.4.44-48. https://elibrary.ru/ylvsdz. (Russian).
Palagin IS, Sukhorukova MV, Dekhnich AV, Edelstein MV, Perepanova TS, Kozlov RS, Shipitsyna EV, Khusnutdinova TA, Kulchavenya EV. Antimicrobial resistance of pathogens causing community-acquired urinary tract infections in Russia: results of multicenter study "DARMIS-2018". Clinical microbiology and antimicrobial chemotherapy. 2019;21(2):134-146. https://doi.org/10.36488/cmac.2019.2.134-146. https://elibrary.ru/vdyqtb. (Russian).
Plehanov VN. On the problems of diagnosis purulent-destructive forms of acute pyelonephritis in young males. RUDN Journal of Medicine. 2010;1:172-177. (Russian).
Abdullin II, Alekseev BJ, Al-Shukri SH, Aljaev JG, Apolihin OI, Bebeshko EV, Beshliev DA, Borisenko EA, Borovec SJu, Burov VN, Vorobev NV, Volkova MI, Derevjanko TI, Dzeranov NK, Dorofeev SD, Evdokimov VV, Ergakov DV, Kamalov AA, Kovalev VA, Kogan MI, Komjakov BK, Krivoborodov GG, Lopatkin NA, Loran OB, Managadze LG, Martov AG, Maslov SA, et al. Urologija. Lopatkin NA, editor. Moskva: GJeOTAR-Media; 2013. 1024 p. (Russian).
Evdochkova TI, Gurko NA. Possibilities of echography and computer tomography in diagnostics of kidney carbuncle on clinical example. Health and Ecology Issues. 2009;2:147-151. edn: SZLTRK. (Russian).
Ignashin NS, Safarov RM, Hodyreva LA, Petrov DA, Vinogradov JeV. Diagnostika ostrogo pielonefrita s primeneniem ultrazvukovyh metodov. Zdravoohranenie Bashkortostana. 2001;S5:97-101. edn: VCINRX. (Russian).
Parenti GC, Passari A. Acute pyelonephritis. Role of diagnostic imaging. Radiol Med. 2001;101(4):251-254.
Kawashima A, LeRoy AJ. Radiologic evaluation of patients with renal infections. Infect Dis Clin North Am. 2003;17(2):433-56.https://doi.org/10.1016/s0891-5520(03)00007-2.
Dubskiy SA. Early diagnostics of purulent pyelonephritis. Bulletin of Russian State Medical University. 2002;2:49-51. edn: KUSLYL. (Russian).
Dubskiy SА, Timoshin SТ, Petrichko МІ. Conservative treatment of purulent destructive forms of acute uncomplicated pyelonephritis. Far Eastern medical journal. 2010;1:82-85. edn: KUSLYL. (Russian).
Goncharova YM, Kuzmenko VV, Kuzmenko AV. Promising directions in the treatment of acute pyelonephritis (literature review). Journal of new medical technologies. 2012;19(2):291-296. edn: PBGKBB. (Russian).
Ostryj pielonefrit. Klinicheskie rekomendacii. 2019 [Internet]. Available from: https://bsmp-kursk.ru/assets/files/local-protocols/Urology/kr-ostryj-pielonefrit.pdf (Russian).
Aljaev JuG, Glybochko PV, Pushkar DJu, editors. Urology. Russian clinical guidelines. Moskow: Medforum; 2017. 544 p. (Russian).
Perepanova TS, Kozlov RS, Rudnov VA, Sinyakova LA. Antibacterial therapy and prevention of infections of the kidneys, urinary tract and male genital organs. Federal Clinical Guidelines. Moskva: Prima-print; 2017. 72 p. edn: YWVYDB. (Russian).
Nechiporenko AN, Vasilevich DM, Yutsevich GV, Nechiporenko NA. Acute purulent pyelonephritis of the single kidney. Journal of the Grodno State Medical University. 2022;20(3):355-358. https://doi.org/10.25298/2221-8785-2022-20-3-355-358. https://elibrary.ru/fiidrq. (Russian).
Sinyakova LA. Antibacterial therapy of acute pyelonephritis. Effective Pharmacotherapy. 2016;11:34-39. edn: WHOVRN. (Russian).
Schetinin VV, Kourbatov DG, Zhadanova OA, Dubsky SA. Role of ultrasound and MRI in the diagnosis of acute pyelonephritis. Medical visualization. 2005;1:62-66. edn: XXLVBZ. (Russian).
Okhotnikov АI, Shumakova EA, Ozerov AA, Chaplygina SV, Kryukov AA. Ultrasonic diagnostics of serous and purulent forms of acute pyelonephritis. Kursk Scientific and Practical Bulletin "Man and His Health". 2011;1:61-67. edn: OIGUMJ. (Russian).
Balci A, Karazincir S, Sangün O, Gali E, Daplan T, Cingiz C, Eğilmez E. Prevalence of abdominal ultrasonographic abnormalities in patients with sickle cell disease. Diagn Interv Radiol. 2008;14(3):133-1337.
Ostryj pielonefrit u vzroslyh. Klinicheskie rekomendacii [Internet]. Moskow; 2016. Available from: https://medi.ru/klinicheskie-rekomendatsii/ostryj-pielonefrit-u-vzroslykh_14142/ (Russian).
Ananev VA, Lubyansky VG. Circulatory Condition in Kidney Patients with Pururlent Pyelonephritis. Journal of Experimental and Clinical Surgery. 2018;11(3):202-207. https://doi.org/10.18499/2070-478X-2018-11-3-202-207. https://elibrary.ru/mfmrdf. (Russian).
Karimova ND. Pielonefrit: jetiologija, klinika, diagnostika, lechenie (obzor literatury). Molodoj uchenyj. 2020;7:297-299. edn: OPUTTS. (Russian).
Novinsky AA, Zinukhov AF. Emphysematous pyelonephritis: epidemiology, modern approaches to diagnosis and treatment. Experimental and Clinical Urology. 2020;13(5):100-105. https://doi.org/10.29188/2222-8543-2020-13-5-100-105. https://elibrary.ru/tfqlnv. (Russian).
Huang JJ, Tseng CC. Emphysematous pyelonephritis: clinicoradiological classification, management, prognosis, and pathogenesis. Arch Intern Med. 2000;160(6):797-805. https://doi.org/10.1001/archinte.160.6.797.
Konoplya AI, Bratchikov OI, Kholimenko IM, Shatokhin MN, Dzharimok AR, Mavrin MYu, Loktionov AL. Condition of the immune status at patients with the serous and purulent pyelonephritis according. Urologiia. 2016;2:10-17. edn: VZZFSZ. (Russian).
Shatokhin MN, Konoplya AI, Kholimenko IM, Besprozvanniy VI, Mavrin MYu. Immune disturbances in acute pyelonephritis. Part II. Urologiia. 2019;5:110-115. https://doi.org/10.18565/urology.2020.1.110-114. https://elibrary.ru/vmhhop. (Russian).
Velkov VV. Presepsin - the early and highly specific marker of sepsis: the new opportunities. Kliniko-laboratornyj konsilium. 2014;3-4:4-31. edn: TCUMKL. (Russian).
Chernova YG, Neymark AI, Momot AP. The role of presepsin in the estimation of disease severity and assessment the treatment efficiency in patients purulent pyelonephritis. Urologiia. 2018;5:22-27. https://doi.org/10.18565/urology.2018.5.22-26. https://elibrary.ru/ytbvsh. (Russian).
Popkov VM, Dolgov AB, Zakharova NB, Ponukalin AN, Varaksin NA. Urinary biomarkers in acute pyelonephritis. Saratov Journal of Medical Scientific Research. 2013;9(1):110-115. edn: QBNWJN. (Russian).
Shchuplova EA, Kuzmin MD. The additional criterion for the diagnosis of purulent-destructive forms of acute pyelonephritis. Urologiia. 2019;2:5-8.https://doi.org/10.18565/urology.2019.2.5-8. https://elibrary.ru/xqfihz. (Russian).
