输尿管软镜碎石术后全身炎症反应综合征的危险因素分析

Analysis the risk factors of systemic inflammatory response syndrome after flexible ureteroscopic lithotripsy

目的探讨输尿管软镜碎石术后全身炎症反应综合征(SIRS)的危险因素。方法回顾性分析2014年1月～2018年1月在我院行输尿管软镜碎石术的125例患者的临床资料,根据术后是否发生SIRS将患者分为SIRS组(26例)与未发生SIRS组(99例)。采用Logistic回归分析输尿管软镜碎石术后SIRS的可能危险因素。结果两组患者的结石部位、有无一期清石、有无初发结石、有无肾积水比较,差异无统计学意义(P>0.05);SIRS组患者的女性、年龄>65岁、尿路感染、手术时间>120 min、糖尿病和肾功能不全发生率均高于未发生SIRS组,差异有统计学意义(P<0.05);Logistic回归分析显示,尿路感染、手术时间、性别、年龄、合并糖尿病及合并肾功能不全是术后SIRS的危险因素(P<0.05)。结论积极控制术前尿路感染,缩短手术时间,对女性、高龄、糖尿病、肝功能不全的患者术前采取针对性防治和护理措施,可有效预防或减少输尿管软镜碎石术后SIRS的发生。

Objective To explore the risk factors of systemic inflammatory response syndrome(SIRS)after flexible ureteroscopic lithotripsy.Methods The clinical data of 125 patients who underwent flexible ureteroscopic lithotripsy in our hospital from January 2014 to January 2018 were retrospectively analyzed,patients were divided into SIRS group(26 cases)and non-SIRS group(99 cases)according to whether SIRS occurred after operation.Logistic regression was used to analyze the possible risk factors of SIRS after flexible ureteroscopic lithotripsy.Results There was no significant difference in calculus location,primary stone clearance,primary stone and hydronephrosis between the two groups(P>0.05).The incidence of female,age>65 years old,urinary tract infection,operation time>120 minutes,diabetes mellitus and renal insufficiency in SIRS group were higher than those in SIRS group,the differences were significant(P<0.05).Logistic regression analysis showed that urinary tract infection,operation time,sex,age,diabetes mellitus and renal insufficiency were risk factors for SIRS(P<0.05).Conclusion Active control of preoperative urinary tract infection,shorten the operation time,and take pertinent preventive and nursing measures for female,elderly,diabetic and liver dysfunction patients before operation can effectively prevent or reduce the occurrence of SIRS after flexible ureteroscopic lithotripsy.