[The treatment of acute suppurative pyelonephritis in diabetes mellitus patients].
The analysis of clinical, diagnostic and treatment efficacy data has been made for 160 diabetes mellitus patients (50 cases of insulin-dependent and 110 of noninsulin-dependent) with acute purulent pyelonephritis (APP). A diffuse form of the disease was detected in 100 patients (62.5%), purulent-destructive one in 60 patients (37.5%). Intoxication, resistant to insulin decompensation of diabetes mellitus, sepsis may be resultant from latent APP. Nondestructive forms of APP were responsive to antibacterial and detoxication therapy combined with catheterization of the urinary tracts. On demand, conservative therapy was reinforced with renal drainage by nephrostomy. Primary nephrectomy was recommended in purulent-destructive forms and purulent para-nephritis. Radical surgery in intensive and advanced purulent-destructive pyelonephritis produced a decrease in postoperative lethality by 26.8%. Adequate therapeutic policy provided positive results in 80% of the patients. Lethal outcomes (20%) were due to grave diabetes mellitus and APP.
Dovlatian
A A
AA
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000473:pathology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology / Q000628:therapy; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009403:Nephrostomy, Percutaneous; D011704:Pyelonephritis / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*
D000900:Anti-Bacterial Agents
Lechenie ostrogo gnoĭnogo pielonefrita u bol'nykh sakharnym diabetom.