输尿管软镜碎石术后患者发生全身炎症反应综合征的影响因素分析

发布时间：2018-09-08 21:18

【摘要】：目的探讨输尿管软镜碎石术后患者发生全身炎症反应综合征(SIRS)的影响因素。方法收集医院泌尿外科2012年1月-2016年12月收治的296例泌尿系结石患者的临床资料,所有患者住院后均行输尿管软镜碎石术(FURL),分析SIRS的发生率及发生SIRS的相关因素,并应用多因素非条件logistic回归分析术后患者发生SIRS的独立影响因素。结果纳入患者中25例术后发生SIRS,发生率为8.45%;SIRS发生与性别、肾结石大小、肾积水程度、手术时间长短、结石培养及术前中段尿培养阳性等因素相关(P0.05),与结石位置及年龄无相关性(P0.05);术前中段尿培养阳性56例,阳性率为18.9%,结石培养阳性62例,阳性率为20.9%,其中大肠埃希菌和葡萄球菌累计检出率60%;logistic回归分析显示,性别、手术时间、肾积水程度和结石培养阳性是FURL后SIRS发生的独立影响因素(P0.05)。结论 FURL术后发生SIRS相关因素较多,临床医师需严格控制手术时间,依据手术前后培养结果,合理应用抗菌药物,降低术后SIRS发生率,提高诊疗质量。
[Abstract]:Objective to investigate the influencing factors of systemic inflammatory response syndrome (SIRS) in patients after ureteral soft lithotripsy. Methods the clinical data of 296 patients with urinary calculi were collected from January 2012 to December 2016. The incidence of SIRS and the related factors of SIRS were analyzed by (FURL), after hospitalization. Multivariate non-conditional logistic regression analysis was used to analyze the independent influencing factors of SIRS. Results the incidence of SIRS, in 25 patients was 8.45%. The incidence of Sirs was related to sex, size of renal calculi, degree of hydronephrosis, length of operation. The positive rate of stone culture was 18.9, the positive rate of stone culture was 62 cases, the positive rate of stone culture was 18.9, but not related to the location of stone and age (P0.05). The positive rate was 20.9. The cumulative positive rate of Escherichia coli and Staphylococcus was 60% logistic regression analysis showed that sex, operation time, hydronephrosis degree and positive stone culture were independent factors influencing the occurrence of SIRS after FURL (P0.05). Conclusion there are many factors related to the occurrence of SIRS after FURL. Clinicians should strictly control the time of operation. According to the results of culture before and after operation, the rational use of antimicrobial agents can reduce the incidence of postoperative SIRS and improve the quality of diagnosis and treatment.
【作者单位】：宁波市北仑区人民医院泌尿外科;浙江大学医学院附属第一医院泌尿外科;
【基金】：浙江省医学会临床科研基金资助项目(2011ZYC-A02)
【分类号】：R699

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