经皮肾镜术后尿源性脓毒血症相关危险因素的Meta分析

Risk factors of urosepsis after percutaneous nephrolithotomy:A meta-analysis

目的分析经皮肾镜碎石取石术(PCNL)术后并发尿源性脓毒血症术前相关危险因素。方法运用Meta分析方法综合分析2006年1月至2016年12月PCNL术后尿源性脓毒血症相关危险因素的研究文献。结果共筛选出相关文献18篇,经分析结果显示有9个危险因素差异具有统计学意义(P<0.05),其OR值及95%CI分别为:女性3.89(2.07,7.31);年龄(≥60岁)1.71(1.23,2.39);糖尿病3.15(2.10,4.72);血常规(白细胞≥10×10~9/L)2.86 (1.66,4.92);尿常规(白细胞≥+)2.43(1.35,4.37);尿培养(阳性)1.60(1.12,2.29);结石大小(≥2 cm)1.94(1.49,2.54);鹿角形结石3.07(1.78,5.31);肾积水(中重度)1.57(1.02,2.43)。结论高龄(≥60岁)、女性、合并糖尿病或术前感染、结石≥2 cm、鹿角形结石、肾积水较重的患者PCNL术后更易发生尿源性脓毒血症。

Objective To analyze the preoperative risk factors related to urosepsis after percutaneous nephrolithotomy.Methods Related literatures about risk factors of urosepsis after percutaneous nephrolithotomy from January 2006 to December 2016 were explored by meta-analysis.Results Eighty studies were selected for meta-analysis,and 9 factors had statistical significances(P<0.0.5).Urosepsis-related factors were as follows:female OR=3.89[95%CI(2.07,7.31)],age(≥60 Y)OR=1.71[95%CI(1.23,2.39)],diabetes mellitus OR=3.15[95%CI(2.10,4.72)],blood routine(White blood cells≥10×10^9/L)OR=2.86[95%CI(1.66,4.92)],urine routine(White blood cells≥+)OR=2.43[95%CI(1.35,4.37)],urobacterial culture(Positive)OR=1.60[95%CI(1.12,2.29)],stone size(≥2 cm)OR=1.94[95%CI(1.49,2.54)],staghorn stone OR=3.07[95%CI(1.78,5.31)],hydronephrosis(moderatesevere)OR=1.57[95%CI(1.02,2.43)].Conclusions Patients who were female,≥60 years old,with diabetes mellitus,or preoperative infection history,larger stones(≥2 cm),staghorn stone or heavy renal hydroponectomy are more likely to have urosepsis after PCNL surgery.