输尿管镜碎石术后尿脓毒血症多因素分析

发布时间：2018-05-02 18:24

本文选题：输尿管镜碎石术 + 尿源性脓毒血症　；参考：《苏州大学》2014年硕士论文

【摘要】：目的输尿管镜碎石术继发尿源性脓毒血症是严重并发症。通过分析输尿管镜碎石术相关尿源性脓毒血症发生的危险因素，探讨其发病特点和诊治要点。方法收集昆山市中医院2009年7月~2013年7月期间642例输尿管镜碎石术患者的临床资料，对37例继发尿源性脓毒血症患者的临床指标进行单因素及多因素Logistic回归分析，找到输尿管镜碎石术继发尿源性脓毒症的相关危险因素。结果 1.642例输尿管镜碎石术患者中，继发尿源性脓毒血症患者37例，发病率为5.7%。经过积极治疗，治愈34例，好转1例，死亡2例（0.3%）。 2.单因素分析显示：高龄（70岁）、女性、糖尿病、术前中段尿细菌培养阳性、手术时间1小时与并发尿源性脓毒血症相关，具有统计学差异（P 0.05）。 3.多因素分析显示：女性、糖尿病、术前中段尿培养阳性、手术时间1小时是并发尿源性脓毒血症的独立危险因素，具有统计学差异（P0.05）。 4.结石大小、息肉包裹与继发尿源性脓毒血症无关，不具有统计学差异（P0.05）。结论 1女性、糖尿病，术前中段尿培养阳性、手术时间长（1小时）是输尿管镜碎石术继发尿源性脓毒血症的独立高危因素，，在输尿管镜碎石术围手术期要高度重视，积极预防。 2高龄（70岁）病人虽相关，但非独立危险因素 3大体积结石（1cm）和息肉包裹梗阻不是输尿管碎石术后继发尿脓毒血症相关危险因素。
[Abstract]:Purpose Ureteroscopic lithotripsy secondary to ureteral sepsis is a serious complication. The risk factors of ureteral sepsis associated with ureteroscopic lithotripsy were analyzed, and the characteristics, diagnosis and treatment of ureteroscopic lithotripsy were discussed. Method The clinical data of 642 ureteroscopic lithotripsy patients from July 2009 to July 2013 in Kunshan Hospital of traditional Chinese Medicine were collected. Univariate and multivariate Logistic regression analysis was performed on 37 patients with secondary ureteral sepsis. To find the risk factors for ureteral sepsis secondary to ureteroscopic lithotripsy. Result Among the 1.642 patients with ureteroscopic lithotripsy, 37 cases were secondary ureteral sepsis, the incidence was 5.7. After active treatment, 34 cases were cured, 1 case improved and 2 cases died. 2. Univariate analysis showed that the age of 70 years old, female, diabetes mellitus, before the middle segment of urine bacteria culture positive, the operation time of 1 hour and complicated with urinary sepsis, there was statistical difference (P 0.05). 3. Multivariate analysis showed that: female, diabetes mellitus, positive urine culture before operation, operation time of 1 hour were the independent risk factors of urinary sepsis, there was statistical difference (P 0.05). 4. The size of stone and polyp were not related to secondary urinary sepsis, and there was no statistical difference (P 0.05). Conclusion 1 female, diabetes mellitus, positive urine culture before operation and long operation time (1 hour) are the independent high risk factors of ureteroscopic lithotripsy secondary to ureterogenic sepsis. We should attach great importance to the perioperative period of ureteroscopic lithotripsy and actively prevent it. (2 aged 70 years) although the patient is related, it is not independent risk factor. (3) large volume stone (1 cm) and polyp encapsulated obstruction were not risk factors for secondary urinary sepsis after ureteral lithotripsy.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R459.7;R699.4

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