经皮肾镜取石术后感染性并发症的危险因素分析

Risk factors of infectious complications after percutaneous nephrolithotomy

目的分析经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)术后感染性并发症的危险因素。方法选取2015年8月至2020年2月海口市人民医院收治的178例接受PCNL治疗的患者,按照患者术后感染性并发症发生情况,将其分别纳入感染组和非感染组,分析患者术后感染性并发症发生情况,并采用多因素Logistic回归分析探讨患者术后感染性并发症的危险因素。结果178例患者中,共有32例术后发生感染性并发症,发生率为17.98%。32例患者均为细菌感染,共检出病原菌46株,以革兰氏阴性菌为主,占69.57%。感染组与非感染组患者年龄、性别比例、合并糖尿病比例、手术时间、重度积水、结石数量比较差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,女性、合并糖尿病、手术时间≥1 h、重度积水均为患者行PCNL术后发生感染性并发症的独立危险因素(均P<0.05)。结论PCNL术后患者感染性并发症发生风险较高,影响因素包括性别、合并症、手术时间、积水程度等,应注重高危感染患者的早期评估和干预,尽可能预防术后感染性并发症的发生。

Objective To analyze the risk factors of infectious complications after percutaneous nephrolithotomy(PCNL).Method A total of 178 patients who were treated with PCNL from August 2015 to February 2020 were selected.According to the incidence of postoperative infectious complications,the patients were included into infection group and non-infection group,and the incidence of postoperative infectious complications was analyzed.Multivariate Logistic regression analysis was used to analyze the relevant factors affecting the incidence of postoperative infectious complications.Result Of the 178 patients,32 cases had postoperative infectious complications,the incidence was 17.98%.All 32 patients were infected by bacteria,46 strains of pathogenic bacteria were detected,mainly Gram-negative bacteria,accounting for 69.57%.There were significantly differences in age,sex ratio,combined diabetes mellitus ratio,operation time,severe hydrops and stone number between infected group and non-infected group(all P<0.05).Women,complicated with diabetes mellitus,operation time≥1 h,and severe hydrops were independent risk factors for postoperative infectious complications of PCNL(all P<0.05).Conclusion Patients with infectious complications after PCNL have a high risk of occurrence.Its influencing factors include gender,complications,operation time,degree of water accumulation.Early assessment and intervention of high-risk infected patients should be paid attention to in order to prevent the occurrence of postoperative infectious complications as much as possible.