腔内碎石术治疗上尿路结石后发生感染的危险因素分析

Risk factors of infection after intracavity fithotripsy for upper urinary tract calculi

目的分析影响腔内碎石术治疗上尿路结石后发生感染的危险因素。方法回顾性分析2013年8月至2018年3月于本院行腔内碎石术治疗的362例上尿路结石患者临床资料,按术后感染情况进行分组,65例感染患者纳入感染组,297例未发生感染患者纳入未感染组,采用统计学方法处理两组患者临床资料,总结发生感染的危险因素。结果单因素方差分析发现,感染组性别、术前感染史、糖尿病、结石部位、肾积水严重程度、结石负荷等指标与未感染组比较,差异均有统计学意义(均P<0.05),以上因素与腔内碎石术治疗上尿路结石后感染发生有关;对单因素方差分析中有统计学意义的指标进行多因素回归分析,结果发现性别为女性、合并肾及UPJ结石、术前感染、糖尿病、重度肾积水及结石负荷大是感染发生的独立危险因素,差异均有统计学意义(均P<0.05)。结论行腔内碎石术治疗上尿路结石前应加强对性别、合并症、结石及肾积水严重程度等特征的筛查,并给予针对性处理。

Objective To investigate the risk factors of infection after intracavity fithotripsy for upper urinary tract calculi. Methods The clinical data of 362 patients with upper urinary tract calculi who underwent endoscopic lithotripsy from August, 2013 to March, 2018 were retrospectively analyzed. According to thepostoperative infection, 65 patients with infection were included in the infection group, and 297 patients without infection were included in the non-infection group. The clinical data of the two groups were processed by statistical method;and the risk factors of infection were summarized. Results Univariate analysis of variance showed that there were statistical differences in gender, preoperative infection history, diabetes mellitus, stone location, hydronephrosis severity, and stone load between the infection group and the non-infection group (all P < 0.05). The above factors were related to the infection after endoscopic lithotripsy for upper urinary tract calculi. Multivariate regression analysis showed that sex, kidney and UPJ stones, preoperative infection, diabetes mellitus, severe hydronephrosis, and high stone load were independent risk factors for infection (all P < 0.05). Conclusions Before endoscopic lithotripsy for upper urinary tract calculi, screening of sex, complications, calculi, and hydronephrosis severity should be strengthened, and targeted treatment should be given.