经皮肾取石术后脓毒症的危险因素  

Risk factors of sepsis derived from post-percutaneous nephrolithotomy

作　　者：吴国忠[1] 孙忠凯[1] 钟葆文 

机构地区：[1]梅州市人民医院泌尿三科,广东梅州514031

出　　处：《岭南现代临床外科》2015年第2期215-218,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨降低经皮肾取石术后脓毒症的有效途径。方法回顾性分析2004年6月至2014年6月期间,在我院行经皮肾取石术的9332例肾结石患者的临床资料,术后并发尿源性脓毒症93例,对患者的年龄、性别、术前有无尿路感染以及经皮肾手术时间等一系列因素与脓毒症发生的关系进行分析。结果经单因素分析,女性患者(P<0.05)、结石>20 mm(P<0.05)、有糖尿病史(P<0.05)、术前未使用抗生素(P<0.05)与经皮肾取石术后脓毒症具有明显的相关性;经多因素回归分析,女性患者(P<0.05)、有糖尿病史(P<0.05)为经皮肾取石术后脓毒症的危险因素;经过积极治疗之后,有82例患者最终均痊愈出院,11例死亡,死亡原因为弥散性血管内凝血,全身多个器官发生功能衰竭。结论女性和有糖尿病史为经皮肾取石术后脓毒症的危险因素,对高危患者在手术之前进行抗感染治疗能够有效降低经皮肾取石术后脓毒症的发生。Objective To investigate risk factor of post percutaneous nephrolithotomy（PCNL）sepsis. Methods A retrospective analysis from June 2004 to June 2014 was performed in 9332 cases with kidney stones. All patients underwent surgical procedure of percutaneous nephrolithotomy and postoperative urinary-derived sepsis was found in 93 cases. The age, gender, presence of urinary tract infection, and preoperative percutaneous renal surgery time and a series of factors associated with sepsis were analyzed. Results Through a one-way factor analysis, female patients（P 0.05）,stones 20 mm（P 0.05）, history of diabetes（P 0.05）, not the use of antibiotics（P 0.05） and preoperative percutaneous nephrolithotomy were associated with PCNL sepsis. Multivariate regression analysis showed that female patients（P0.05）, history of diabetes（P0.05） were risk factors for PCNL sepsis. Of 93 cases, 82 were cured, 11 died of disseminated intravascular coagulation and multiple organ dysfunction. Conclusion Women and history of diabetes are risk factor to induce to PCNL sepsis. The high-risk patients deserve the standard preoperative antibiotic preparation.

关 键 词：肾结石 经皮肾取石术 重症脓毒症 有效途径 

分 类 号：R692.4[医药卫生—泌尿科学]