上尿路结石术后感染的病原菌及相关因素分析

Analysis of pathogens and related factors of postoperative infection in patients with upper urinary calculi

分析上尿路结石(UUC)术后感染的病原菌及相关因素。回顾2 500例行内镜碎石治疗的UUC术后感染发生率,分析所有对象临床特征与术后感染症状发生的关联性,并探讨存在感染症状的患者病原菌分布占比情况,结果显示UUC患者内镜碎石术治疗后感染症状发生率较高,年龄≥60岁、女性、合并糖尿病、结石>5 cm、急性梗阻、手术类型、手术时间延长等项目均对感染的发生有显著影响,UUC合并感染患者主要致病菌为革兰阴性菌,大肠埃希菌是导致感染发生的主要革兰阴性致病菌,粪肠球菌是主要革兰阳性菌致病菌,临床治疗需根据药敏试验结果结合患者自身情况综合制定用药方案,在保证安全性的同时提高治疗效果,改善预后。

To analyze the etiology and related factors of postoperative infection in patients with upper urinary calculi(UUC).The incidence of infection after UUC in 2 500 patients treated with endoscopic lithotripsy was reviewed,the relationship between clinical features and postoperative infection symptoms was analyzed,and the distribution of pathogenic bacteria in patients with infection symptoms was discussed.The results showed that the incidence of infection symptoms was higher in patients with UUC after endoscopic lithotripsy.Age≥60 years old,female,complicated with diabetes,calculus>5 cm,acute obstruction,operation type,prolonged operation time and other items have a significant impact on the occurrence of infection.The main pathogenic bacteria of UUC complicated infection patients are Gram-negative bacteria,E.coli was the main Gram-negative pathogen causing the infection.Enterococcus faecalis was the main pathogen of Gram-positive bacteria.Clinical treatment should be based on the results of drug sensitivity test in combination with the patient's own situation to formulate a comprehensive drug program,while ensuring safety while improving the treatment effect and improve the prognosis.