盲升结肠可控膀胱术后上尿路感染危险因素多元逐步回归分析

Risk factors of urinary tract infection after detenia cecal colon continent reservoir operation

目的 建立多元回归方程 ,了解根治性膀胱全切、去带盲升结肠储尿囊、阑尾或回肠输出道可控膀胱术后上尿路感染的发病危险因素。 方法 对 1995～ 1998年 31例根治性膀胱全切去带盲升结肠储尿囊可控膀胱术患者进行问卷式随访 ,多因素逐步回归分析尿流改道后上尿路感染的发病危险因素。 结果 门坎值F =3 .84引入变量 ,回归方程 ^Y =0 .6 32 + 0 .40 5x1- 0 .0 94x2 - 0 .5 2 0x3+ 0 .2 44x4 - 0 .15 4x5。 结论 膀胱全切盲升结肠储尿囊尿流改道后 ,肾盂输尿管积水、自主生活能力下降、日间导尿间歇过长易引起上尿路感染 。

Objective To study the risk factors of upper urinary tract infection after total cystectomy and detenia cecal colon continent urinary reservoir operation. Methods 31 patients underwent total cystectomy and detenia cecal colon continent reservoir undertaken from 1995 to 1998 were investigated by questionnaire.The risk factors of upper urinary tract infection were analyzed with multiple factor stepwise regression analysis. Results A regression equation was established as followed:=0.632+0.405x 1- 0.094 x 2-0.520x 3+0.244x 4-0.154x 5.The threshold F=3.84 was introduced into the equation. Conclusions The incidence of upper urinary tract infection was significantly high following total cystectomy and urinary diversion for patients with bladder or prostate malignancy.Hydronephrosis,disablement and long interval catheterization during daytime might induce upper urinary tract infection easily whereas periodical rinsing of the urinary reservoir and regular sterilization of the urethral catheter would provide protective effects for upper urinary tract against infection.