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目的:探讨输尿管软镜碎石术后尿源性脓毒血症发生的相关危险因素,为碎石术后尿源性脓毒血症的预防提供临床依据。方法:选择368例在我院接受输尿管软镜碎石术的肾结石患者作为研究对象,将其中27例并发尿源性脓毒血症的患者纳入研究组,341例未并发尿源性脓毒血症的患者纳入对照组。回顾性分析两组患者的临床资料包括一般资料、手术记录及检验指标,对两组患者的相关资料进行单因素分析与Logistic多因素回归分析。结果:单因素分析结果显示,性别、结石直径、术前尿培养阳性、手术时间及合并糖尿病与碎石术后尿源性脓毒血症的发生有关(χ2=3.921~24.788,P=0.000~0.046)。Logistic多因素回归分析显示,女性、术前尿培养阳性、手术时间长及合并糖尿病是碎石术后尿源性脓毒血症发生的独立危险因素。结论:输尿管软镜碎石术后并发尿源性脓毒血症与多种因素相关,其中女性、术前尿培养阳性、手术时间长及合并糖病是碎石术后尿源性脓毒血症发生的独立危险因素,临床上应针对上述危险因素加强预防。
Objective: To investigate the related risk factors of urinary sepsis after ureteroscopic lithotripsy and provide the clinical evidence for the prevention of urinary sepsis after lithotripsy. Methods: A total of 368 renal calculi patients undergoing ureteroscopic lithotripsy in our hospital were selected as study subjects. Twenty-seven patients with urinary sepsis were enrolled in the study group. 341 patients without urinary sepsis Patients with sepsis were included in the control group. Retrospective analysis of two groups of patients clinical data including general information, surgical records and test indicators, the two groups of patients related information univariate analysis and Logistic regression analysis. Results: The results of univariate analysis showed that gender, diameter of stones, positive urine culture before operation, operation time and diabetes mellitus were associated with the occurrence of urinary sepsis after ostomy (χ2 = 3.921-24.788, P = 0.000 ~ 0.046). Logistic multivariate regression analysis showed that women, positive preoperative urine culture, long duration of surgery and diabetes mellitus were independent risk factors of urinary sepsis after lithotripsy. Conclusion: Urealytic lithotripsy associated with urinary sepsis is related to many factors, including female, preoperative urinary culture positive, long duration of operation and complicated with diabetes mellitus after urolithiasis Disease independent risk factors, clinical risk factors should be strengthened against the above-mentioned prevention.