经皮肾镜碎石取石术后并发感染危险因素  

Risk factors for infection following percutaneous nephrolithotomy

作　　者：路璐[1] 李小顺[1] 何丽萍[1] 林鸣[1] 

机构地区：[1]武警陕西总队医院,陕西西安710054

出　　处：《中国感染控制杂志》2015年第1期35-37,共3页Chinese Journal of Infection Control

摘　　要：目的了解患者经皮肾镜碎石取石术后并发感染的危险因素,为预防患者术后感染提供依据。方法选择2010年8月—2013年8月某院住院行经皮肾镜碎石取石术患者96例,对其临床资料进行回顾性分析,对患者术后感染情况、危险因素及分离病原体等进行分析。结果经皮肾镜碎石取石术后,发生感染35例,感染率为36.46%(35/96)。单因素分析结果显示,结石大小、形状、手术时间以及灌注量是患者术后感染的危险因素(均P<0.05)。对术前96例患者和术后18例患者进行尿细菌培养,共检出病原菌39株,其中大肠埃希菌占首位(12株),其次为铜绿假单胞菌(8株)、草绿色链球菌(5株)、肺炎克雷伯菌(4株)和阴沟肠杆菌(3株)等。结论经皮肾镜取石术后并发感染率高;进行此类手术时,应做好充足地术前准备,有效减少手术时间和术中灌注量;同时,合理使用抗菌药物,以改善患者术后感染情况。Objective To explore the risk factors for infection following percutaneous nephrolithotomy（PCNL）, and provide the basis for prevention of postoperative infection.Methods 96 patients who were performed PCNL in a hospital between August 2010 and August 2013 were chosen,clinical data of patients were retrospectively analyzed, the occurrence of postoperative infection,risk factors and isolated pathogens were analyzed.Results 35 patients （36.46%[35/96]）developed infection following PCNL.Univariate analysis revealed that risk factors for postopera-tive infection were the size and shape of stone,duration of operation,and intraoperative perfusion （all P 〈0.05）. 96 patients before operation and 18 patients after operation were performed bacterial culture for urine,a total of 39 strains were isolated,the main isolated pathogens was Escherichia coli （n=12）,followed by Pseudomonas aerugi-nosa （n=8）,Streptococcus viridans （n =5 ）,Klebsiella pneumoniae （n =4）and Enterobacter cloacae （n =3 ）. Conclusion Infection rate following PCNL is high,duration of operation and intraoperative perfusion should be re-duced,antimicrobial agents should be used rationally.

关 键 词：肾结石 经皮肾镜碎石取石术 泌尿外科 并发症 危险因素 医院感染 

分 类 号：R692.4[医药卫生—泌尿科学] R181.32[医药卫生—外科学]