肾结石患者术后泌尿系感染与结石复发的相关因素分析  

Related factors for postoperative urinary tract infection and stone recurrence in kidney stone patients

作　　者：王斌[1] 陶佳意[1] 汪兴旺[1] 柳琦[1] 吴有才[1] 

机构地区：[1]湖北省黄冈市中心医院泌尿外科,湖北黄冈438000

出　　处：《中华医院感染学杂志》2016年第13期3026-3027,3068,共3页Chinese Journal of Nosocomiology

基　　金：湖北省科技厅重点攻关科研基金资助项目(201303261310)

摘　　要：目的分析肾结石患者术后泌尿系感染与结石复发的相关因素,为临床预防治疗泌尿系感染和结石复发提供理论指导与依据。方法选取2012年11月-2014年10月医院收治的肾结石患者75例,所有患者行输尿管镜碎石术(URL)或URL联合体外冲击波碎石术(ESWL),分析临床相关资料,判断患者泌尿系感染情况,采用回归分析术后泌尿系感染与结石复发的相关因素。结果尿常规WBC>+++患者13例,感染5例,感染率38.5%,WBC<++或正常者62例,感染6例,感染率9.7%,差异有统计学意义(P<0.05);8例患者住院时间≥10d,感染3例,感染率37.5%,67例住院时间<10d,感染5例,感染率7.5%,差异有统计学意义(P<0.05);1年后随访,尿常规WBC>+++的患者中肾结石复发率达53.8%;WBC正常患者的结石复发率6.5%,泌尿系感染患者中复发率54.5%,经logistic回归分析,患者年龄、尿WBC、住院时间及术后有无泌尿系感染为肾结石复发的多发因素。结论肾结石术后泌尿系感染是结石复发的关键因素,需密切关注肾结石患者术后的泌尿系感染预防与控制,减少肾结石的复发率。OBJECTIVE To explore the related factors for postoperative urinary tract infection and stone recurrence in kidney stone patients so as to provide theoretical bases for clinical prevention and treatment of the urinary tract infection and stone recurrence.METHODS A total of 75 patients with kidney stones who were treated in the hospital from Nov 2012 to Oct 2014 were enrolled in the study,all the patients received ureteroscopy lithotripsy（URL）or URL combined with extracorporeal shock wave lithotripsy（ESWL）,the related clinical data were analyzed,the prevalence of urinary tract infection was determined,and the regression analysis was performed to observe the related factors for the urinary tract infection and stone recurrence.RESULTS Of 13 patients with the urine routine WBC more than＋＋＋,5had the infection,with the infection rate 38.5%;of 62 patients with WBC less than＋＋ or normal WBC,6had the infection,with the infection rate 9.7%,and there was significant difference（P〈0.05）.The infection occurred in 3of 8patients with the length of hospital stay no less than 10 days,with the infection rate 37.5%;the infection occurred in 5of 67 patients with the length of hospital stay less than 10 days,with the infection rate 7.5%,and there was significant difference（P〈0.05）.A one-year follow-up showed that the recurrence rate of kidney stone was 53.8%in the patients with the urine routine WBC more than ＋＋＋,6.5%in the patients with normal WBC,54.5%in the patients with urinary tract infection.The logistic regression analysis indicated that the kidney stone recurrence was associated with a variety of factors,including the age,urine WBC,length of hospital stay,and occurrence of postoperative urinary tract infection.CONCLUSION The postoperative urinary tract infection is a leading factor for the stone recurrence in the kidney stone patients,therefore,it is necessary to focus on the prevention and control of postoperative urinary tract infections so as to reduce the recurrence rate of kidney stone.

关 键 词：肾结石术后 泌尿系感染 结石复发 相关因素分析 

分 类 号：R691.3[医药卫生—泌尿科学]