肾输尿管腔内微创术后尿源性脓毒血症患者临床治疗效果及诱发感染的相关因素分析

Clinical therapeutic effect of patients with postoperative urine-derived sepsis undergoing kidney ureter minimally invasive surgery and related factors for induced infections

目的探讨肾输尿管腔内微创术后尿源性脓毒血症患者的临床治疗效果及诱发感染的相关因素,为临床治疗提供理论指导与依据。方法选取2012年5月-2015年5月于医院收治的肾输尿管腔内微创术患者62例作为研究对象,对患者的临床资料进行回顾性分析,观察患者术中临床表现、术后实验室化验结果,对诱发感染的相关因素进行回归分析;采用SPSS16.0软件进行统计分析。结果 62例患者中轻微脓毒血症患者42例、严重脓毒血症20例;对所有患者进行治疗后,58例患者痊愈出院,均无明显后遗症,另外4例患者因自身原因,救治无效后死亡,治愈率为93.55%;单因素分析结果显示,年龄>60岁、女性、患有糖尿病、术前尿培养阳性、手术时间>1h及尿源性脓毒血症并发感染发生具有相关性(P<0.05);多因素logistic回归分析结果显示,糖尿病、女性、术前尿培养结果阳性、手术时间>1h是尿源性脓毒血症患者并发感染的独立危险因素。结论糖尿病、女性、术前尿培养结果阳性、手术时间>1h是尿源性脓毒血症患者并发感染的独立危险因素,应实施有针对性的预防措施,以提高临床治疗效果。

OBJECTIVE To observe the effect of clinical treatment of patients with postoperative urine-derived sepsis undergoing kidney ureter minimally invasive surgery and analyze the related factors for induced infections so as to provide theoretical guidance and basis for the clinical treatment.METHODS A total of 62 patients who underwent the kidney ureter minimally invasive surgery from May 2012 to May 2015 were recruited as the study objects,then the clinical data of the patients were retrospectively analyzed,the intraoperative clinical manifestations and results of postoperative laboratory tests were observed,the regression analysis was carried out for the related factors for the induced infections,and the statistical analysis was performed with the use of SPSS16.0software.RESULTS Among the 62 patients,there were 42 patients with mild and moderate sepsis and 20 patients with severe sepsis.Totally 58 patients were cured and discharged after the treatment,none of them had obvious sequelae,4patients died due to their own reasons and ineffective treatment,and the cure rate was 93.55%.The univariate analysis showed that the incidence of the infections in the patients with urine-derived sepsis was associated with the more than 60 years of age,female,diabetic mellitus,positive preoperative urine culture,and operation duration more than 1hour（P〈0.05）.The multivariate logistic regression analysis indicated that the independent risk factors for the complicated infections in the patients with urine-derived sepsis included the diabetic mellitus,female,positive preoperative urine culture,and operation duration more than 1hour.CONCLUSION The independent risk factors for the complicated infections in the patients with urine-derived sepsis include the diabetic mellitus,positive preoperative urine culture,and operation duration more than 1hour.It is necessary to take targeted prevention measures so as to improve the clinical therapeutic effect.