微通道经皮肾镜碎石术后感染性休克的危险因素分析

Risk Factors of Septic Shock Following the Mini-Percutaneous Nephrolithotripsy

目的:探讨微通道经皮肾镜碎石术(M-PCNL)后发生感染性休克的相关危险因素,以评估M-PCNL手术的安全性。方法:回顾性分析2009年7月至2012年12月于我科接受M-PCNL手术209例患者的资料。应用卡方检验统计学方法评估手术时间、手术部位、年龄、性别、结石大小、尿路感染及培养、术前是否合并基础疾病等11个因素对M-PCNL术后发生感染性休克的影响。结果:209例患者中,5例术后出现感染性休克,发生率0.024%(5/209)。11个因素中,女性和糖尿病患者是发生感染性休克的危险因素(P<0.05)。结论:女性、糖尿病患者是M-PCNL术后发生感性性休克的危险因素。术前应预防性给予静脉抗生素治疗,术中保持肾盂低灌注压、术后早期诊断、及时治疗并发症。

Objective： To explore the risk factors, prevention, and management of the septic shock fol- lowing the mini-percutaneous nephrolithotripsy （M-PCNL）. Methods： A total of 209 patients who underwent M-PCNL from July 2004 to December 2012 were retrospectively analyzed. Eleven factors were analyzed as follow： operative time, age, gender, urine culture, operation route, hy- pertension, diabetes mellitus, urinary tract infection, preoperative serum creatinine, history of stone surgery, stone size, etc. Chi-square test method was used for analysis. Results： Five of 209 patients developed septic shock, with an incidence rate of 0. 024% （5/209）, and two factors as female and diabetes mellitus were shown as the independent related factors to septic shock follow- ing mini-PCNL （both P〈0.05）. Conclusion： Female and diabetes mellitus are the risk factors for septic shock following M-PCNL. Perioperative preventive measures can reduce the incidence of septic shock. Early recognition and timely treatment may decrease the mortality.