ОСТРЫЙ ГНОЙНЫЙ ПИЕЛОНЕФРИТ (ОБЗОР ЛИТЕРАТУРЫ). ЧАСТЬ II – ЛЕЧЕНИЕ
Аннотация
Острый гнойный пиелонефрит представляет собой серьезное заболевание, требующее адекватного лечения, поскольку без него возможны тяжелые осложнения, включая сепсис и септический шок с высокой смертностью. Традиционно основным методом лечения острого гнойного пиелонефрита было открытое хирургическое вмешательство, однако в последние годы наблюдается переход к более современным и менее инвазивным методам, таким как эндовидеохирургические операции, которые обеспечивают более быструю реабилитацию и сокращение сроков госпитализации. После операции пациентам назначается эмпирическая антибактериальная терапия для достижения высокой концентрации антибиотиков в почечной ткани. Однако, несмотря на достижения в лечении, сохраняется высокая частота осложнений, таких как уросепсис и острая почечная недостаточность, что приводит к необходимости нефрэктомии и высокой послеоперационной летальности. Важно также учитывать резистентность микроорганизмов к антибиотикам, что требует индивидуального подхода к выбору терапии. Современные подходы к лечению острого гнойного пиелонефрита включают не только хирургические методы, но и экстракорпоральные методы детоксикации и медикаментозную иммунокоррекцию. Восстановление оттока мочи из пораженной почки является критически важным для успешного лечения, так как это позволяет улучшить эффективность антибактериальной терапии. Важно продолжать исследования для оптимизации методов лечения и определения наилучшего времени для хирургического вмешательства, что может способствовать сохранению функции почки и улучшению исходов для пациентов.
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