恒压灌注下经皮肾镜碎石(PCNL)术后尿源性脓毒血症的危险因素探讨

The risk factors of urogenic sepsis after percutaneous nephrolithotripsy(PCNL)under constant pressure perfusion

目的 探讨恒压灌注下经皮肾镜碎石(PCNL)术后尿源性脓毒血症的危险因素.方法 对160例恒压灌注下PCNL术患者性别、年龄、术前尿培养、结石直径、手术时间等临床资料进行调查和统计,将术后出现尿源性脓毒血症患者纳入研究组,将未出现尿源性脓毒血症患者纳入对照组,并分析患者术后发生尿源性脓毒血症的危险因素.结果 160例患者术后出现尿源性脓毒血症26例,发生率为16.25%;研究组患者术前尿路感染、女性、结石面积≥800mm^(2)、手术时间≥90min、糖尿病占比高于对照组,差异有统计学意义(P<0.05),多因素分析表明,术前尿路感染、结石面积、性别、手术时间、糖尿病是患者术后诱发尿源性脓毒血症的独立危险因素(P<0.05).结论 恒压灌注下PCNL术后患者发生尿源性脓毒血症与尿路感染、结石面积、性别、手术时间、糖尿病有密切关联,需根据危险因素做好相应防护措施,以降低患者术后出现此类并发症的风险.

Objective To investigate the risk factors of urogenic sepsis after percutaneous nephrolithotripsy(PCNL)under constant pressure perfusion.Methods Investigation and statistics of 160 patients with PCNL perfusion by sex,age,preoperative urine culture,stone diameter,operation time and other clinical data,patients with urogenic sepsis were included in the study group,patients without urogenic sepsis were included in the control group,and the risk factors of urogenic sepsis were analyzed.Results In 160 patients with 26 postoperative sepsis,the incidence was 16.25%;the proportions of urinary tract infection,female,stone area≥800mm^(2),operation time≥90min,and diabetes in the study group were higher than those in the control group,the difference was statistically significant(P<0.05).Multimultiple analysis,preoperative urinary tract infection,stone area,gender,operation time,and diabetes mellitus were independent risk factors for postoperative sepsis in patients(P<0.05).Conc lusion The occurrence of urinary sepsis in patients after PCNL under constant pressure perfusion is closely related to urinary tract infection,stone area,gender,operation time and diabetes,and corresponding protective measures should be taken according to risk factors to reduce the risk of such complications after surgery.