无发热结石性脓肾患者微创术后炎症综合征的影响因素

Influence factors of systemic inflammatory reaction syndrome of apyrexic calculous pyonephrosis patients after percutaneous nephrolithotripsy

目的探讨无发热结石性脓肾患者行经皮肾镜碎石术(PCNL)后全身炎症反应综合征(SIRS)的影响因素。方法选取住院行PCNL患者286例,根据是否发生全身炎症反应综合征(SIRS),将患者分为SIRS组56例和非SIRS组230例。统计患者一般临床资料和各实验室指标,对比分析各个因素对SIRS发生的影响。结果单因素分析显示,两组患者在结石数量、手术时间、术前使用抗生素、肾功能不全、手术是否为单通道、术中灌洗液流速、是否需要输血和术前尿路感染方面均存在显著性差异(P<0.05或P<0.01),Logistic回归分析显示以上因素为SIRS发生的独立危险因素。结论为降低PCNL术后发生SIRS的风险,对结石数量多、肾功能不全、术前未使用抗生素、术前尿路感染的患者应给予相关预防处理,术中尽量缩短手术时间,开单通道,降低灌洗液流速和出血量。

Objective To analyze the influence factors of systemic inflammatory reaction syndrome （SIRS） of apyrexic calculous pyonephrosis patients after percutaneous nephrolithotripsy （PCNL）. Method 286 patients undergoing PCNL were divided into SIRS group （n： 56） and non-SIRS group （n= 230）. The general clinical data and experiment da- ta were collected and analyzed. Results Single factors analysis showed that there was significant difference between stone number, operation duration, with antibiotics before operation, rental insufficiency, tract, douche follow rate, with or without transfusion and urinary tract infection of two groups （P〈0.05 or P〈0. 01）. Logistic regression analysis indica- ted that all these factors were dependent risk factors of SIRS after PCNL. Conclusion In order to decrease the occurrence rate of SIRS, the patients with many stones, renal insufficiency, unused antibiotics before operation and urinary tract in- fection were treated with related measures before operation, and should be decreased the operation time, douche follow rate and bleeding.