摘要
目的分析肾结石合并糖尿病患者行输尿管软镜钬激光碎石术后尿路感染的危险因素。方法于2018年1月-2019年12月,选择航空总医院收诊且行输尿管软镜钬激光碎石术治疗的98例肾结石合并糖尿病患者作为研究对象,回顾性分析患者的临床资料,统计患者术后尿路感染发生情况。采用单因素和多因素Logistic回归分析输尿管软镜钬激光碎石术后发生尿路感染的危险因素。结果 98例患者均顺利完成输尿管软镜钬激光碎石术,术后有17例患者发生尿路感染,术后尿路感染发生率为17.35%。单因素分析结果显示年龄≥60岁、体质量指数≥25 kg/m^2、术前血清蛋白水平<30 g/L、术前尿路感染、结石直径≥2 cm、术前尿路梗阻、手术时间≥2 h、输尿管内支架管留置时间≥7 d、未预防性应用抗菌药物是糖尿病肾结石患者术后尿路感染的影响因素(P<0.05);经多因素Logistic回归分析,年龄、体质量指数、术前血清蛋白水平、术前尿路感染、结石直径、术前尿路梗阻、手术时间、输尿管内支架管留置时间、预防性应用抗菌药物是尿路感染发生的独立危险因素。结论年龄大、体质量指数高、术前血清蛋白水平低、术前尿路感染、结石直径大、术前尿路梗阻、手术时间长、输尿管内支架管留置时间长、未预防性应用抗菌药物的糖尿病肾结石术后患者应重视预防术后尿路感染。
OBJECTIVE To investigate the risk factors for urinary tract infection in the renal calculi patients complicated with diabetes mellitus after ureteroscopic holmium laser lithotripsy.METHODS A total of 98 renal calculi patients complicated with diabetes mellitus who received ureteroscopic holmium laser lithotripsy in Aviation General Hospital from Jan 2018 to Dec 2019 were recruited as the study objects,the clinical data of the patients were retrospectively analyzed,the incidence of postoperative urinary tract infection was statically analyzed,and univariate analysis and multivariate logistic regression analysis were performed for the risk factors for the postoperative urinary tract infection in the ureteroscopic holmium laser lithotripsy patients.RESULTS The ureteroscopic holmium laser lithotripsy was successfully completed for all of the 98 patients,17 patients had urinary tract infection after the surgery,with the incidence of postoperative urinary tract infection 17.35%.Univariate analysis indicated that the influencing factors for the postoperative urinary tract infection in the patients with diabetic nephrolithiasis included the no less than 60 years of age,body mass index no less than 25 kg/m^2,preoperative serum protein less than 30 g/L,preoperative urinary tract infection,diameter of stone no less than 2 cm,preoperative urinary obstruction,operation duration no less than 2 hours,indwelling time of ureteral stent no less than 7 days and prophylactic use of antibiotics.Multivariate logistic regression analysis showed that the age,body mass index,preoperative serum protein,preoperative urinary tract infection,diameter of stone,preoperative urinary tract obstruction,operation duration,indwelling time of ureteral stent and prophylactic use of antibiotics were the independent risk factors for the urinary tract infection.CONCLUSION The old age,high body mass index,low level of preoperative serum protein,preoperative urinary tract infection,great diameter of stone,preoperative urinary obstruction,long operation duration,long indwelling time of ureteral stent and no prophylactic use of antibiotics are the risk factors for the postoperative urinary tract infection in the patients with diabetic nephrolithiasis.
作者
刘昕
丁峰
LIU Xin;DING Feng(Aviation General Hospital,Beijing 100012,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第14期2188-2191,共4页
Chinese Journal of Nosocomiology
关键词
肾结石
糖尿病
尿路感染
输尿管软镜
钬激光碎石术
危险因素
Renal calculi
Diabetes mellitus
Urinary tract infection
Flexible ureteroscope
Holmium laser lithotripsy
Risk factor
