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史新莉 沈俊文.输尿管软镜下钬激光碎石取石术后患者并发尿脓毒血症的影响因素分析[J].中国现代医生,2021,59(23):52-55
输尿管软镜下钬激光碎石取石术后患者并发尿脓毒血症的影响因素分析
Analysis of the influencing factors of urinary sepsis in patients undergoing retrograde intrarenal surgery under flexible ureteroscope
  
DOI:
中文关键词:  输尿管结石  输尿管软镜下钬激光碎石术  尿脓毒血症  影响因素
英文关键词:Ureteral calculi  Holmium laser lithotripsy under flexible ureteroscope  Urinary sepsis  Influencing factor
基金项目:浙江省医药卫生科技计划项目(2020KY937)
作者单位
史新莉 沈俊文 浙江省湖州市第一人民医院泌尿外科浙江湖州 313000 
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中文摘要:
      目的 探讨输尿管软镜下钬激光碎石术(RIRS)术后患者并发尿脓毒血症的影响因素。方法 回顾性分析2017年12月至2019年12月期间本院采用RIRS治疗的316例输尿管结石患者的临床资料。将术后并发尿脓毒血症的患者纳入发生组,将未并发尿脓毒血症的患者纳入未发生组。比较两组一般资料,并将术后并发尿脓毒血症可能的影响因素纳入自变量并为其赋值,经多项Logistic 回归分析找出RIRS 术后并发尿脓毒血症的影响因素。结果 316例经RIRS治疗的患者术后并发尿脓毒血症18例,发生率为5.70%(18/316);单因素分析结果显示,年龄、性别、结石直径≥20 mm、多发结石、手术时间>70 min、肾功能不全、C-反应蛋白(CRP)异常、降钙素原(PCT)异常均可能是RIRS 术后并发尿脓毒血症的影响因素(P<0.05)。经非条件Logistic 回归分析,结石直径≥20 mm、多发结石、肾功能不全(Scr、SUN)、CRP 异常、PCT 异常均是影响RIRS 术后并发尿脓毒血症的危险因素(OR>1,P<0.05)。结论 建议临床在实施RIRS 术前应评估患者是否伴尿脓毒血症风险因素,针对存在风险者,应积极采取干预,可能对减少术后尿脓毒血症发生有积极意义。
英文摘要:
      Objective To explore the influencing factors of urinary sepsis after retrograde intrarenal surgery (RIRS) under flexible ureteroscope.Methods The clinical data of 316 cases of ureteral calculi treated by RIRS in our hospital from December 2017 to December 2019 were retrospectively analyzed.Patients with postoperative urinary sepsis were included in the occurrence group,and those without concurrent urinary sepsis were included in the non-occurrence group.The general data of the two groups were compared.The possible influencing factors of postoperative urinary sepsis were included in the independent variables and assigned a value to them.The influencing factors of postoperative urinary sepsis after RIRS were found out by multiple Logistic regression analysis.Results There were 18 cases of postoperative urinary sepsis in 316 patients treated by RIRS,with an incidence of 5.70%(18/316).Univariate analysis showed that age,sex,calculi diameter ≥20 mm,multiple calculi,operation time >70 min,renal insufficiency,abnormal C-reactive protein (CRP),and abnormal PCT were all possible influencing factors for urinary sepsis after RIRS(P<0.05).According to the non-conditional Logistic regression analysis,calculi diameter≥20 mm,multiple calculi,renal insuffi ciency (Scr,SUN),abnormal CRP,and abnormal PCT were all risk factors affecting urinary sepsis after RIRS (OR>1,P<0.05).Conclusion It is suggested that the risk factors for urinary sepsis should be evaluated before the implementation of RIRS,and active intervention should be taken for those at risk,which may be of positive significance for reducing the occurrence of postoperative urinary sepsis.
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