术后系统性炎症反应综合征与经皮肾镜碎石术前中段尿及术中肾盂尿的相关研究

Relationship of postoperative systemic inflammatory response syndrome and preoperative midway through the urine and perioperative renal pelvis urine of percutaneous nephrostolithotomy v

目的探讨术后系统性炎症反应综合征（SIRS）与经皮肾镜碎石术（VCNL）术前中段尿及术中肾盂尿的相关陛。方法共纳入450例行PCNL的尿路结石患者，均于PCNL术前留取中段尿，并于术中留取肾盂尿。结果450例患者中，术前中段尿细菌培养阳性100例（22．2％，100／450），术中肾盂尿细菌培养阳性85例（18．9％，85／450）；46例（10．2％，46／450）术后发生SIRS。术中肾盂尿细菌培养阳性患者中20例（23．5％，20／85）术前中段尿细菌培养阳性，术中肾盂尿细菌培养阴性患者中80例（21．9％，80／365）术前中段尿细菌培养阳性，两者比较差异无统计学意义（P〉0．05）。术前中段尿细菌培养阳性患者中15例（15．0％，15／100）出现SIRS，术前中段尿细菌培养阴性患者中3l例（8．9％，31／350）出现SIRS，两者比较差异无统计学意义（P〉0．05）。术中肾盂尿细菌培养阳性患者中18例（21．2％，18185）出现SIRS，术中肾盂尿细菌培养阴性患者中28例（7．7％，28／365）出现SIRS，两者比较差异有统计学意义（P〈0．05）。结论术前中段尿与术后SIRS的发生无显著相关性，术中肾盂尿细菌培养阳性可以预测术后SIRS的发生，给予相应的抗生素治疗可以提高PCNL的安全性。

Objective To explore the relationship of postoperative systemic inflammatory response syndrome （SIRS） and preoperative midway through the urine and perioperative renal pelvis urine of pereutaneous nephrostolithotomy （PCNL）. Methods Participants included 450 patients with urinary calculus who underwent PCNL, preoperative midway through the urine and perioperative renal pelvis urine of PCNL was collected. Results Of 450 cases,preoperative midway through the urine germiculture positive 100 cases （22.2%, 100/450 ）,perioperative renal pelvis urine germiculture positive 85 eases （18.9%, 85/450）, 46 cases （ 10.2%, 46/450） occurred SIRS after PCNL. Decompression of perioperative renal pelvis urine germicuhure positive 20 cases （23.5% ,20/85） preoperative midway through the urine germicuhure positive, perloperative renal pelvis urine the bacteria cultures negative 80 eases （21.9%, 80/365） preoperative midway through the urine germieulture positive （P 〉0.05）,＇ preoperative midway through the urine germieulture positive 15 eases （15.0%, 151100） in SIRS, preoperative midway through the urine the bacteria cultures negative 31 cases （ 8.9%, 31/350） in SIRS （P 〉 0.05 ）. Decompression of perioperative renal pelvisurine germicuhure positive 18 cases （21.2%, 18/85 ） in SIRS, perioperative renal pelvis urine the bacteria cultures negative 28 cases （7.7%, 28/365 ） in SIRS （P 〈 0.05 ）. Conclusion Preoperative midway through the urine has no correlation with the occurrence of SIRS, perioperative renal pelvis urine germiculture positive can predict the occurrence of SIRS, giving corresponding antibiotic treatment can improve the security of PCNL.