摘要
目的探讨输尿管结石患者在采用输尿管软镜治疗后出现感染的高危因素。方法选取2016年1月至2019年2月江油市九○三医院泌尿外科将诊治的150例输尿管软镜治疗输尿管结石患者作为研究对象。将因输尿管结石行输尿管软镜术治疗且出现术后感染患者设为感染组(n=88),将治疗后未出现感染患者设为未感染组(n=62)。比较两组患者的病原菌检测、血清学指标,以及结石大小、结石数量、结石位置、术前发热、术前尿路感染、抗生素应用情况、软镜类型、手术时间、糖尿病史、合并胃肠道疾病情况等,分析其出现感染的高危因素。结果感染组患者尿培养感染阳性率90.91%(80例),血培养感染阳性率93.18%(82例);感染组术后血清CRP、ESR、PCT、WBC值均高于未感染组,差异均具有统计学意义(均P<0.05)。两组患者结石大小、结石数量、术前发热、术前尿路感染、术前应用抗生素、糖尿病史因素比较,差异具有统计学意义(P<0.05);两组患者结石位置、手术时间、软镜类型、合并胃肠道疾病因素比较,差异无统计学意义(P>0.05)。危险因素中结石≥16mm、结石多发、术前发热、术前尿路感染、术前应用抗生素、合并糖尿病是术后感染危险因素(P<0.05)。结论输尿管软镜治疗输尿管结石患者的术后感染高危因素较多,术前应全面评估临床资料,随时监测患者的血清学指标水平,还应重视术前感染因素并做好抗感染治疗,降低患者的术后感染率。
Objective To investigate the high risk factors of postoperative infection in the treatment of urinary calculi by flexible ureteroscopy.Methods After flexible ureteroscopy for ureteral calculi in Department of Urology Surgery of Jiangyou 903 Hospital from January 2016 to February 2019,patients with postoperative infection were selected as the infection group(n=88),and patients without infection as the uninfected group(n=62).The detection of pathogenic bacteria,serological indicators,stone size,number of stones,location of stones,preoperative fever,preoperative urinary tract infection,application of antibiotics,type of soft mirrors,operation time,history of diabetes,and complicated gastrointestinal diseases were compared between the two groups to analyze their highrisk factors for infection.Results The positive rate of urine culture was 90.91%(80 cases),and the positive rate of blood culture was 93.18%(82 cases).Postoperative serum CRP,ESR,PCT and WBC values of the infected group were all higher than those of the non-infected group,and the differences were statistically significant(all P<0.05).There were statistically significant differences between the two groups in stone size,stone number,preoperative fever,preoperative urinary tract infection,preoperative antibiotic use,and history of diabetes(P<0.05).There were no statistically significant differences between the two groups in stone location,operation time,type of soft mirror and factors associated with gastrointestinal diseases(P>0.05).Calculi≥16mm,multiple calculi,preoperative fever,preoperative urinary tract infection,preoperative antibiotics,and diabetes were the risk factors for postoperative infection(P<0.05).Conclusions There are many high risk factors for postoperative infection in patients with ureteral calculi treated by flexible ureteroscopy.Preoperative comprehensive clinical data should be evaluated,serological index level of patients should be monitored at any time,and preoperative infection factors and anti-infection treatment should be paid attention to reduce postoperative infection rate of patients.
作者
陈亮
刘勇
刘强
李金祥
李新会
李昱昊
CHEN Liang;LIU Yong;LIU Qiang;LI Jinxiang;LI Xinhui;LI Yuhao(Department of Urology Surgery,Jiangyou 903 Hospital,Jiangyou 621700,Sichuan,China)
出处
《中国性科学》
2020年第10期110-113,共4页
Chinese Journal of Human Sexuality
关键词
输尿管软镜
输尿管结石
感染
高危因素
Flexible ureteroscopy
Urinary calculi
Infection
High-risk factors
