肾囊肿患者去顶减压与硬化治疗术后发热因素相关分析与防治

Analysis and prevention of postoperative fever of renal cyst

目的 探讨肾囊肿患者术后引起发热的相关因素及防治措施。方法 回顾性分析2018年1月至2021年12月杭州市第一人民医院应用腹腔镜肾囊肿去顶减压和肾囊肿硬化治疗150例患者的临床资料,包括年龄、性别、部位、直径,术前是否合并非淋菌性尿道炎,术前尿培养、术前尿白细胞、是否合并高血压、糖尿病、手术方式、术后血C反应蛋白(C reactive protein,CRP)、术后血白细胞,并对术后发热患者的开始发热时间、发热最高体温进行记录,术后分为发热组和未发热组,对两组肾囊肿患者术后发热的相关因素,以及发热原因进行分析。结果 术后发热121例,占80.7%。性别、糖尿病、术前尿白细胞计数、术前尿培养、术前合并非淋菌性尿道炎、手术方式两组间比较,差异有统计学意义(P<0.05)。Logistic多因素分析显示糖尿病、术前合并非淋菌性尿道炎是术后发热的独立危险因素(OR>1,P<0.05),术后血CRP差异有统计学意义(P<0.05),术后发热的原因与炎症有关。结论 肾囊肿患者在术前需常规尿细菌培养和尿白细胞计数,彻底治疗尿路感染。肾囊肿硬化治疗可减少术后发热的发生率。糖尿病史和非淋菌性尿道炎是肾囊肿术后发热的独立危险因素。

Objective To investigate the related factors and prevention measures of postoperative fever in patients with renal cyst.Methods Retrospective analysis was made on the clinical data of 150 patients who were treated with laparoscopic renal cyst decapitation and decompression and sclerotherapy in Hangzhou First People’s Hospital from January 2018 to December 2021,including age,gender,location,diameter,preoperative non gonococcal urethritis,preoperative urine culture,preoperative urinary leukocytes,hypertension,diabetes,operation mode,postoperative blood C reactive protein(CRP),and postoperative blood leukocytes,The time of onset of fever and the highest temperature of fever in patients with renal cysts after surgery were recorded.The patients were divided into fever group and non fever group after surgery.The related factors and causes of fever in the two groups were analyzed.Results Postoperative fever occurred in 121 cases(80.7%).There were statistically significant differences in gender ratio,diabetes history,preoperative routine urine white blood cell count,preoperative urine culture,preoperative non-gonococcal urethritis and surgical methods between the two groups(P<0.05).Logistic multivariate analysis showed that the history of diabetes mellitus and preoperative concomitant non-gonococcal urethritis were independent risk factors for postoperative fever(OR>1,P<0.05),postoperative blood CRP difference was statistically significant(P<0.05),postoperative fever was related to infection.Conclusion Patients with renal cyst need routine urine bacterial culture and routine urine white blood cell count before surgery to thoroughly treat urinary tract infection.Renal cyst sclerotherapy is selected to reduce the incidence of postoperative fever.History of diabetes mellitus and non-gonococcal urethritis were independent risk factors for fever after renal cyst.