泌尿系统结石经皮肾镜手术后发生尿源性脓毒血症的影响因素

Analysis factors of urosepsis after percutaneous nephrolithotomy

目的 探讨泌尿系统结石微创取石术后发生尿源性脓毒血症的影响因素.方法 选取在本院行微创经皮肾镜手术患者328例,根据PCNL术后是否发生尿源性脓毒血症,分为尿源性脓毒血症组和非尿源性脓毒血症组.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尿源性脓毒血症发生的影响.结果 尿源性脓毒血症组和非尿源性脓毒血症组在性别比例、结石体积、结石数量、手术时间、存在肾功能不全、是否为鹿角型结石、术中灌注压力、是否存在术前尿路感染和hs-CRP方面比较存在显著性差异（P＜0.05）.经Logistic回归分析显示,结石体积、结石数量、手术时间、肾功能不全、鹿角型结石、术中灌注压力和术前尿路感染是皮肾镜取石术后发生尿源性脓毒血症的独立危险因素（P＜0.05）.结论 结石体积、结石数量、手术时间、肾功能不全、鹿角型结石、术中灌注压力和术前尿路感染是皮肾镜取石术后发生尿源性脓毒血症的独立危险因素.

Objectives To investigate the influencing factors of urosepsis after percutaneous nephrolithotomy for patients with urinary calculus.Methods 328 cases of patients with urinary calculus undergoing percutaneous nephrolithotomy in our hospital were divided into urosepsis group and non-urosepsis group.The general clinical data and experiment data were collected and analyzed.Results Single factors analysis showed that there was significant difference between gender,stone number,stone volume,operation duration,renal insufficiency,staghorn renal stone,washing pressure,urinary tract infection and hs-CRP of two groups （P 〈 0.05 or P 〈 0.01）.Logistic regression analysis showed that stone number,stone volume,operation duration,renal insufficiency,staghorn renal stone,washing pressure,and urinary tract infection were dependent risk factors of urosepsis for patients with urinary calculus undergoing percutaneous nephrolithotomy （P 〈 0.05 or P 〈 0.01）.Conclusions Stone number,stone volume,operation duration,renal insufficiency,staghorn renal stone,washing pressure and urinary tract infection were dependent risk factors of urosepsis for patients with urinary calculus undergoing percutaneous nephrolithotomy.