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目的:探讨经皮肾镜取石术(PCNL)治疗上尿路结石术后发热的影响因素。方法:回顾性分析在我院行经PCNL治疗的89例上尿路结石患者的病例资料,分别对患者的性别、年龄、术前肾积水的程度、结石的大小、尿培养的结果、手术持续的时间以及术中灌注液等情况进行分析,探讨其与PCNL术后发生发热的相关性。结果:本组资料中,发热(>38℃)人数为19人,占21.3%。其中,术前尿培养阳性、结石直径大于3 cm、合并中度及中度以上肾积水、手术持续时间长、灌注液用量多的上尿路结石患者PCNL术后发热的几率明显升高(P<0.05)。而年龄、性别与上尿路结石患者PCNL术后发热的几率无明显相关性(P>0.05)。结论:术前预防性应用广谱抗生素、术中低压灌注、缩短手术时间、术前穿刺引流等都是预防上尿路结石患者PCNL术后发生发热的有效措施。
Objective: To investigate the influencing factors of fever after upper urinary calculi treated with percutaneous nephrolithotomy (PCNL). Methods: The clinical data of 89 patients with upper urinary tract calculi treated with PCNL in our hospital were retrospectively analyzed. The gender, age, degree of preoperative hydronephrosis, the size of the stone, the results of urine culture, the duration of the operation Of the time and intraoperative perfusion fluid analysis of the situation, and PCNL postoperative fever related. Results: The data in this group, fever (> 38 ℃) the number of 19 people, accounting for 21.3%. Among them, preoperative urinary culture positive, stone diameter greater than 3 cm, with moderate and moderate hydronephrosis, long duration of surgery, perfusion fluid and more patients with upper urinary tract stones PCNL postoperative fever was significantly increased (P < P <0.05). There was no significant correlation between age, sex and the incidence of postoperative PCNL fever in upper urinary calculi (P> 0.05). Conclusion: Preoperative prophylactic use of broad spectrum antibiotics, intraoperative low pressure perfusion, shortened operative time, preoperative drainage and drainage are the effective measures to prevent postoperative PCNL fever in patients with upper urinary tract calculi.