国内经皮肾镜取石术后发生全身炎症反应综合征相关因素的Meta分析

发布时间：2018-04-29 13:54

  本文选题：经皮肾镜取石术(PCNL) + 全身炎症反应综合征(SIRS)　； 参考：《中国内镜杂志》2017年09期

【摘要】：目的探讨国内经皮肾镜取石术(PCNL)后发生全身炎症反应综合征(SIRS)的危险因素。方法计算机检索国内有关PCNL术后发生SIRS的相关研究,时间截止至2016年10月,采用Rev Man5.3进行Meta分析。结果共纳入18个研究,5 323例患者,Meta分析结果显示:(1)单因素分析结果 :肾功能不全[OR=2.78,95%CI(1.96,3.95),P=0.000]、术前尿培养细菌阳性[OR=3.41,95%CI(1.89,6.15),P=0.000]、术前尿常规白细胞异常[OR=3.78,95%CI(3.02,4.72),P=0.000]、糖尿病[OR=2.14,95%CI(1.33,3.45),P=0.002]、结石细菌培养阳性[OR=5.14,95%CI(2.46,10.73),P=0.000]和手术时间≥120 min[OR=2.31,95%CI(1.40,3.82),P=0.001]是PCNL术后发生SIRS的危险因素;(2)多因素分析显示:术前尿培养细菌阳性[OR=6.83,95%CI(2.82,16.57),P=0.000]、术前尿常规白细胞异常[OR=5.43,95%CI(3.51,8.41),P=0.000]、糖尿病[OR=2.85,95%CI(1.45,5.58),P=0.002]、结石细菌培养阳性[OR=4.30,95%CI(1.30,14.21),P=0.020]和手术时间≥120 min[OR=2.72,95%CI(1.62,4.59),P=0.000]是PCNL术后发生SIRS的独立危险因素。结论糖尿病、术前尿培养细菌阳性、术前尿常规白细胞异常、结石细菌培养阳性和手术时间是PCNL术后发生SIRS的独立危险因素,受纳入研究数量和质量影响,需开展更多高质量研究证实上述结论。
[Abstract]:Objective to investigate the risk factors of systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL) in China. Methods the relevant studies of SIRS after PCNL were searched by computer, and Meta analysis was performed by Rev Man5.3 as of October 2016. Results the results of meta-analysis of 5 323 patients included in 18 studies showed that the results of univariate analysis were as follows: renal insufficiency [OR2.78-95CII 1.963.95 P0.000], urine culture positive before operation [OR3.41-95CI1.86.15CI1.86.15P0.000], routine urinary leukocyte abnormality [OR3.78-95CI3.024.72], diabetes mellitus [OR2.148-95CI1.333.453.453.453.453.453.45CI1.34], bacterial culture positive. [OR=5.14,95%CI(2.46,10.73),P=0.000]鍜屾墜鏈�鏃堕棿鈮�120 min[OR=2.31,95%CI(1.40,3.82),P=0.001]鏄疨CNL鏈�鍚庡彂鐢烻IRS鐨勫嵄闄╁洜绱，

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