肾结石患者术后泌尿系感染与结石复发的影响因素及相关性研究

Influencing factors for postoperative urinary tract infection and recurrence of nephrolithiasis and their correlation

目的探讨肾结石患者术后泌尿系感染与结石复发的影响因素及其相关性。方法选择2013年1月-2017年5月于医院泌尿外科进行微创手术治疗的82例肾结石患者的资料进行回顾性分析,分别以患者在完成手术后1个月内是否发生泌尿系感染分为A组与B组,完成手术后1年内是否出现肾结石复发分为C组与D组,对肾结石术后泌尿系感染与结石复发的影响因素进行分析。结果在手术后1个月,共有14例患者发生泌尿系感染,感染率为17.07%;Logistic多因素回归分析结果显示,患者的年龄≥65岁,手术前尿WBC"+++",住院时间≥14d,均为患者手术后1个月内发生泌尿系感染的独立影响因素(P<0.05);在手术后1年内,共有16例患者出现肾结石复发,复发率为19.51%;Logistic多因素回归分析结果显示,手术前尿WBC为"+++"、结石成分为感染性结石与手术后出现泌尿系感染,均为患者手术后1年内肾结石复发的独立影响因素(P<0.05)。结论肾结石术后有若干因素可以导致泌尿系感染与结石复发,在临床工作中应对这些因素进行具有针对性的干预。

OBJECTIVE To explore the influencing factors for postoperative urinary tract infection and recurrence of nephrolithiasis in patients with nephrolithiasis and analyze the their correlation.METHODS The data of 82 patients with nephrolithiasis who receive minimally invasive surgery in urology department from Jan 2013 to May 2017 were retrospectively analyzed,the enrolled patients were divided into the group A and the group B according to whether the urinary tract infection occurred within 1 month after the surgery and were divided into the group C and the group D according to whether the nephrolithiasis recurred within 1 year after the surgery.The influencing factors for the postoperative urinary tract infection and recurrence of nephrolithiasis were observed.RESULTS Totally 14 patients had urinary tract infection after the surgery for 1 month,with the infection rate 17.07%.The result of multivariate logistic regression analysis indicated that the no less than 65 years of age,urine WBC ＂＋＋＋＂before surgery and length of hospital stay no less than 14 days were the independent influencing factors for the urinary tract infection within 1 month after the surgery（P〈0.05）.Totally 16 patients had the recurrence of nephrolithiasis within 1 year after the surgery,with the recurrence rate 19.51%.The result of multivariate logistic regression analysis showed that the preoperative urine WBC ＂＋＋＋＂,infectious nephrolithiasis and postoperative urinary tract infection were the independent influencing factors for the recurrence of nephrolithiasis within 1 year after the surgery（P〈0.05）.CONCLUSIONS There are a variety of influencing factors for the urinary tract infection and recurrence of nephrolithiasis after the kidney stone surgery.It is necessary for the hospital to take targeted interventions according to the influencing factors.