输尿管镜碎石患者术后医院感染的相关因素分析

Related factors of nosocomial infections in patients after ureteroscope lithotripsy

目的探讨输尿管镜碎石患者术后感染的相关因素,并根据相关因素制定相应的预防治疗措施,以期降低感染率。方法选取2010年3月-2015年12月医院收治900例上尿路结石患者,采用输尿管镜碎石术进行治疗,统计患者术后感染率,病原菌分布,采用多因素logistic回归分析患者发生医院感染的危险因素,数据采用SPSS18.0统计学软件进行分析处理。结果 900例上尿路结石患者术后发生医院感染35例,感染率为3.9%;共检出病原菌121株,其中革兰阴性菌94株占77.7%,革兰阳性菌26株占21.5%,真菌1株占0.8%;经过单因素及多因素logistic回归分析发现,年龄≥60岁、手术时间长和合并糖尿病是输尿管镜碎石患者术后发生医院感染的独立危险因素。结论控制输尿管镜碎石患者术后感染需分析危险因素和病原菌特征,进行针对性的预防控制措施。

OBJECTIVE To investigate the related factors of infection after ureteroscope lithotripsy,and propose prevention and treatment measures,in order to reduce the infection rate.METHODS A total of 900 patients from Mar.2010 to Dec.2015 with upper urinary tract calculi were treated by ureteroscope lithotripsy.The infection rate after surgery and the pathogens distribution were analyzed.The risk factors were analyzed by multivariate logistic regression analysis,and the data were analyzed by SPSS18.0.RESULTSInfection occurred in 35 patients,and the infection rate was 3.9%.Totally 121 strains of pathogenic bacteria were detected,including 94 strains of gramnegative bacteria（77.7%）,26 strains of gram-positive bacteria（21.5%）,and 1strain of fungi（0.8%）.multivariate logistic regression analysis showed that the ages≥60years old,long operation time and combined with diabetes were the independent risk factors for nosocomial infection in patients after ureteroscope lithotripsy.CONCLUSIONThe prevention and control measures should be carried out according to the risk factors and pathogenic bacteria.