输尿管软镜碎石术后尿源性脓毒血症发生的相关危险因素分析-现代医学

输尿管软镜碎石术后尿源性脓毒血症发生的相关危险因素分析

单位：广西壮族自治区梧州市人民医院泌尿外科, 广西梧州 543000

分类号：R631.2

出版年·卷·期（页码）：2017·36·第十期（1413-1416）

摘要：

目的：探讨输尿管软镜碎石术后尿源性脓毒血症发生的相关危险因素，为碎石术后尿源性脓毒血症的预防提供临床依据。方法：选择368例在我院接受输尿管软镜碎石术的肾结石患者作为研究对象，将其中27例并发尿源性脓毒血症的患者纳入研究组，341例未并发尿源性脓毒血症的患者纳入对照组。回顾性分析两组患者的临床资料包括一般资料、手术记录及检验指标，对两组患者的相关资料进行单因素分析与Logistic多因素回归分析。结果：单因素分析结果显示，性别、结石直径、术前尿培养阳性、手术时间及合并糖尿病与碎石术后尿源性脓毒血症的发生有关（χ²=3.921~24.788，P=0.000~0.046）。Logistic多因素回归分析显示，女性、术前尿培养阳性、手术时间长及合并糖尿病是碎石术后尿源性脓毒血症发生的独立危险因素。结论：输尿管软镜碎石术后并发尿源性脓毒血症与多种因素相关，其中女性、术前尿培养阳性、手术时间长及合并糖病是碎石术后尿源性脓毒血症发生的独立危险因素，临床上应针对上述危险因素加强预防。

Objective: To investigate the risk factors of urinary sepsis after ureteroscopic lithotripsy and provide evidence for the prevention of urinary sepsis after ureteroscopic lithotripsy.Methods: Three hundred and sixty-eight cases of kidney stone patients undergoing ureteroscopic lithotripsy were chosen as study subjects. Among them, 27 patients with urinary sepsis were included in study group,and 341 patients without urinary sepsis were enrolled in control group. The clinical data of the two groups were analyzed, including general information, surgical records and laboratory parameters, by univariate and logistic regression analysis. Results: Univariate analysis showed that gender, stone diameter, positive urine culture before operation, operation time and diabetes mellitus were related to the incidence of urinary sepsis after ureteroscopic lithotripsy(χ²=3.921-24.788,P=0.000-0.046). Logistic regression analysis showed that female, preoperative urine culture positive, long operation time and diabetes mellitus were independent risk factors of urinary sepsis after ureteroscopic lithotripsy.Conclusion: Urinary sepsis after ureteroscopic lithotripsy is related to many factors. Among them, female, preoperative urine culture positive, long operation time and diabetes mellitus are independent risk factors of urinary sepsis after ureteroscopic lithotripsy. Clinical prevention should be strengthened in accordance with the above risk factors.

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