输尿管软镜相关尿源性脓毒血症相关危险因素的Meta分析

Meta-analysis of Risk Factors Associated with Urosepsis Following Flexible Ureteroscopic Lithotripsy

目的:分析输尿管软镜碎石术(FURL)术后并发尿源性脓毒血症相关危险因素。方法:检索Medline、EMBASE、PubMed、CNKI、万方、维普等数据库中关于输尿管软镜碎石术发生脓毒血症危险因素的文献,根据纳入排除标准纳入符合标准的文献,采用MINORS评分对纳入文献进行质量评价;提取数据及运用Review Manager 5.2软件进行数据分析。结果:共筛选出符合标准文献8篇。可提取的8个因素中有6个危险因素具有统计学意义(P<0.05),其OR值及95%CI分别为:女性P<0.0001,OR=1.85[1.36,2.51];糖尿病P=0.00001,OR=2.64[1.94,3.58];尿培养(阳性)P=0.00001,OR=6.19[4.43,8.66];结石大小(>1cm)P=0.01,OR=2.00 [1.18,3.40];手术时间(>60min)P=0.004,OR=2.47[1.38,4.42];结石手术史P=0.02,OR=1.85[1.09,3.14]。结论:女性、糖尿病、尿培养(阳性)、手术时间(>60min)、结石大小(>1cm)、既往结石手术史为FURL术后并发尿源性脓毒血症的危险因素。

Objective: To analyze the risk factors of Urinary Sepsis after flexible Ureteroscopic Lithotripsy(FURL). Methods: Literatures on risk factors of Sepsis after flexible Ureteroscopic Lithotripsy were retrieved from Medline,EMBASE,PubMed,CNKI,Wanfang,VIP.Inclusion of eligible literature according to inclusion and exclusion criteria,the literatures were included in the standard literature.The quality of the included literatures was evaluated by MINORS score.Data analysis was done with Review Manager 5.2 software. Results:A total of 8 articles conforming to the standard were screened out. Six risk factors were statistically significant(P<0.05),the OR value and 95% CI are as follows,female P=0.0001 OR=1.85 [1.36,2.51],diabetes P=0.00001,OR=2.64[1.94,3.58],urine culture(positive) P=0.00001,OR=6.12 [4.38,8.56],stone size(>1 cm) P=0.01,OR=2.00[1.18,3.40],operation time(>60 min)P=0.004,OR=2.47 [1.38,4.42];stone surgery history P=0.02,OR=1.85[1.09,3.14]. Conclusion:Female,diabetes mellitus,urine culture(positive),operation time(>60 minutes),stone size(>1 cm),and previous stone operation history were risk factors for Urinary Sepsis after FURL.