输尿管结石患者术后泌尿道感染危险因素及其列线图模型构建

Risk factors of postoperative urinary tract infection in patients with ureteral calculi and construction of its nomogram model

目的分析输尿管结石患者术后泌尿道感染病原菌分布及其危险因素,并构建相关列线图模型.方法回顾性选择2019年1月—2023年1月山东省淄博市第一医院收治的118例输尿管结石术后泌尿道感染患者为感染组,135例输尿管结石无感染患者为非感染组,统计输尿管结石患者术后泌尿道感染病原学特点,分析输尿管结石患者术后泌尿道感染的危险因素.结果118例输尿管结石术后泌尿道感染患者共分离出129株病原菌,主要感染病原菌种类为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、溶血性链球菌、白假丝酵母;年龄较大、有糖尿病、术前尿潴留、术后导尿管留置时间长、双J管留置时间长、血清白蛋白(ALB)水平较低均为输尿管结石患者术后泌尿道感染的危险因素(P<0.05);列线图模型为:Logit(P)=-9.229+年龄×0.088+糖尿病×0.787+术前尿潴留×1.113+术后导尿管留置时间×0.342+双J管留置时间×0.237-血清ALB水平×0.149;受试者工作特征(ROC)曲线显示,当Logit(P)>0.527时,曲线下面积(AUC)值为0.864,敏感度为73.73%,特异度为85.19%.结论输尿管结石术后泌尿道感染患者主要感染病原菌种类较多,其影响因素与年龄、糖尿病、术前尿潴留、术后导尿管留置时间、双J管留置时间、血清ALB水平有关,相关的列线图模型预测价值良好.

OBJECTIVE To analyze the distribution of pathogens and risk factors of postoperative urinary tract in-fection in patients with ureteral calculi,and to construct a related nomogram model.METHODS From Jan 2019 to Jan 2023,118 patients with urinary tract infection after ureteral calculi surgery admitted to the First Hospital of Zibo City in Shandong Province were retrospectively collected as the infection group,and 135 patients with ureter-al calculi without infection as the non-infection group.The etiological characteristics of postoperative urinary tract infection in patients with ureteral calculi were counted,and the risk factors of postoperative urinary tract infection in patients with ureteral calculi were analyzed.RESULTS A total of 129 strains of pathogenic bacteria were isolated from 18 patients with urinary tract infection after ureteral calculi operation.The main pathogenic bacteria were Escherichia coli,Pseudomonas aeruginosa,Staphylococcus aureus,hemolytic Streptococcus and Candida alba.Older age,diabetes,preoperative urinary retention,long postoperative catheter indwelling time,long double J tube indwelling time,and low serum albumin(ALB)levels were all risk factors for postoperative urinary tract in-fection in urinary tract infection after ureteral calculi.The nomogram model was as follows:Logit(P)=-9.229+age×0.088+diabetes×0.787+preoperative urinary retention×1.113+postoperative catheter retention time×0.342+double J tube retention time×0.237-serum ALB level×0.149.The receiver operating char-acteristic(ROC)curve showed that when logit(P)>0.527,the area under the curve(AUC)value was 0.864,with the sensitivity of 73.73%and the specificity of 85.19%.CONCLUSION There were many kinds of pathogen-ic bacteria in patients with urinary tract infection after ureteral calculi.The influencing factors were related to age,diabetes,preoperative urinary retention,postoperative catheter indwelling time,double J tube indwelling time and level of serum ALB.The relevant nomogram model had good predictive value.