经皮肾镜取石术后并发重症感染的相关因素分析及防治策略  

Related Factors for Severe Infections and Prophylaxis Policy after Percutaneous Nephrostolithotomy

作　　者：孔祥波[1] 张赟[1] 张茁[1] 张刚[1] 马天武[1] 张慕淳[1] 

机构地区：[1]吉林大学中日联谊医院泌尿外科,长春130033

出　　处：《中国医科大学学报》2011年第9期807-809,共3页Journal of China Medical University

摘　　要：目的分析经皮肾镜取石术后并发重症感染的相关因素,探讨如何防治经皮肾镜手术后的重症感染的措施。方法回顾性分析440例肾结石患者的临床资料,均行经皮肾镜取石术,分别对患者是否有梗阻、手术时间、术前是否合并尿路感染,结石大小、年龄结构以及术中灌注液压力等情况与术后并发重症感染发生率的相关性进行分析。结果术后发热(大于38℃)67例,占15.2%,脓毒败血症2例。有急性梗阻、术前已有尿路感染、手术时间长、灌注压力高、结石大、感染性结石的患者术后并发重症感染的发生率明显增高,而年龄、性别等因素对并发重症感染的发生率无显著影响。结论经皮肾镜取石术后发热比较常见,有可能并发重症感染,术前应预防应用广谱抗生素,术中规范操作,尽可能低灌注压灌洗,控制手术时间,术后保持引流管通畅等是预防术后发热的有效措施。Objective To analyze the related factors of severe infections after percutaneous nephrostolithotomy（PCNL） and investigate the more effective preventive measure.Methods To make a retrospective analysis of 440 cases who underwent PCNL for upper urinary tract calculi,and analyze the factors such as obstructive situations,operating time,preoperative urinary tract infection,stone situation,age structure,pressure of irrigation pump,then the statistical relationship with complicated severe infections was investigated.Results 67 cases were with fever（38℃） after PCNLwhich was taking up 15.2%.2 cases were pyemia.Patients with acute obstruction,preoperative urinary infection,long time operation,pump irrigation pressure,the big stone and infectivity calculi were found to have elevated occurrence of severe infection.Age,sex were correlated poorly with the occurrence of severe infections.Conclusion The frequency of fever after PCNL was common,sometimes it might be with severe infections.Effective measures of preventing should be taken,including the using antibacterial agents rationally before the operation,standard operation and low-pressure perfusion,control the operation time and make the drainage to be unobstructed.

关 键 词：经皮肾镜取石术 肾结石 感染 

分 类 号：R693.4[医药卫生—泌尿科学]