PCNL术后脓毒血症并发休克危险因素分析

Risk Factors for Septic Shock after Percutaneous Nephrolithotripsy

目的:评估经皮肾镜取石术(PCNL)术后出现脓毒血症并发休克的危险因素,为预防PCNL术后脓毒血症的发生提供理论及数据支持。方法:选取2005年6月-2013年6月笔者所在医院收治的行PCNL手术的682例患者,分析其临床资料,应用统计学方法分析患者术后脓毒血症并发休克的危险因素。结果:笔者所在医院PCNL术后脓毒血症并发休克率为1.61%,经过统计学分析:性别、是否合并糖尿病及手术时间因素在PCNL术后脓毒血症组与未发生脓毒血症组间比较差异有统计学意义(P<0.05)。结论:建议对于女性患者或糖尿病控制不理想的患者,即使他们的术前尿培养结果为阴性,也应常规使用抗生素。尽可能减少手术时间,可以减少PCNL术后脓毒血症并发休克可能,必要时可行二次手术以减少术后并发脓毒血症风险。

Objective：To evaluate the risk factors for septic shock after percutaneous nephrolithotripsy（PCNL） and provide a theoretic basis for the prevention of septic shock after PCNL.Method：Selection from June 2005 to June 2013,the author’s hospital treated PCNL procedure in 682 patients,analyzing the clinical data,applying statistical methods to analyze patients with risk factors for postoperative sepsis and shock.Result：The incidence of septic shock after PCNL was 1.61%. Logistic regression analysis identified female sex and diabetes mellitus and operative time as independent risk factors for post-PCNL septic shock. Conclusion：Suggestions for female patients or patients with diabetes control is not ideal,even if their preoperative urine culture results were negative,should also be routine use of antibiotics. As far as possible to reduce the operation time,can reduce PCNL sepsis complicated with postoperative shock may,when necessary and feasible by sepsis after second operation in order to reduce risk.