经皮肾镜取石术后全身炎症反应综合征的危险因素分析

Risk factors analysis of systemic inflammatory response syndrome following percutaneous nephrolithotomy

目的:探讨经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)术后发生全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)的危险因素。方法:回顾性分析114例一期行PCNL术的肾结石患者的临床资料,根据患者术后是否发生SIRS分为两组,通过logistic回归分析评价各因素与术后发生SIRS的相关性。结果:114例患者成功接受一期PCNL手术,其中21例(18.4%)术后发生SIRS。与非SIRS组比较,SIRS组的术前尿常规白细胞、亚硝酸盐及尿培养结果阳性率高,且铸型结石的比例更高,差异均有统计学意义(P<0.05),而非SIRS组患者一期结石清除率为76.3%(71/93),SIRS组患者一期结石清除率为52.4%(11/21),差异有统计学意义(P<0.05)。多因素回归分析显示术前尿常规白细胞阳性、铸型结石是PCNL术后发生SIRS的相关危险因素(P<0.05)。结论:术前尿常规白细胞阳性及铸型结石是PCNL术后发生SIRS的危险因素。

Objective:To evaluate the risk factors of systemic inflammatory response syndrome(SIRS)after percutaneous nephrolithotomy(PCNL).Methods:A retrospective analysis was performed on 114 renal stone patients who underwent PCNL.The patients were divided into two groups according to the occurrence of SIRS after PCNL.Logistic regression analysis was used to screen the risk factors of SIRS after PCNL.Results:All 114 patients successfully underwent PCNL,and 21 patients(18.4%)developed SIRS.Compared with the non-SIRS group,the preoperative positive urinary leukocytes,nitrite and urine culture results in the SIRS group were higher,as well as the cast mould stone,with statistically significant difference(P<0.05).The first-stage stone clearance in the non-SIRS group was 76.3%(71/93),while in the SIRS group was 52.4(11/21),with statistically significant difference(P<0.05).Multivariate regression analysis showed that preoperative positive urinary leukocytes and cast mould stone were the risk factors for SIRS after PCNL(P<0.05).Conclusion:Preoperative positive urinary leukocytes and cast mould stone were the risk factors for SIRS after PCNL.