经皮肾镜碎石取石术术后并发感染的危险因素分析及预防  

Analysis and Prevention of Risk Factors of Concurrent Infection after Percutaneous Nephrolithotomy

作　　者：吴久龙[1] 李巧星[1] 郑红芳[1] 黄振华[1] 

机构地区：[1]江苏大学附属昆山医院泌尿外科,江苏昆山215300

出　　处：《系统医学》2017年第13期91-93,共3页Systems Medicine

摘　　要：目的对经皮镜碎石取石术术后并发感染的影响因素进行分析,并探讨有效的防治措施。方法将自2010年1月—2016年12月在该院接受经皮肾镜碎石取石术治疗的380例患者临床资料进行分析,观察术后感染患者的临床资料,并采用Logistic回归多因素分析对感染危险因素进行分析,针对危险因素给予防控、治疗措施。结果380例手术治疗患者中发生感染29例,占7.63%;术后细菌培养结果显示,大肠埃希菌是主要致病菌,占65.5%,其次为白色假丝酵母菌(13.8%)、粪链球菌(10.3%);Logistic回归分析发现患者合并基础疾病、高龄、结石形状、大小、手术时间、冲洗液灌注压力及灌注量、术后出血是导致术后患者发生感染的危险因素(P<0.05)。结论经皮肾镜碎石取石术后具有较高的并发感染率,因此在手术前需要对患者基本情况、结石状况进行综合评估并做好充分的预防准备,治疗基础疾病,尽可能的降低术中灌注压力及减少手术时间,术前、术中及术后预防性使用抗生素以减少术后感染发生。Objective This pap er tries to analyze the influencing factors of concurrent infection after percutaneous nephrolithotomy, and to explore effective prevention and treatment measures. Methods The clinical data of 380 patients treated with percutaneous nephrolithotomy from January 2010 to December 2016 were analyzed. The clinical data of patients with postoperative infection were observed and the risk of infection was analyzed by logistic regression. The prevention and treatment measures were put forward based on the risk factors. Results 29 cases were infected during the operation, accounting for 7.63% . The results of bacterial cultivation showed that escherichia coli was the main pathogen, accounting for 65.5%, followed by candida albicans of 13.8%, fecal chain of 10.3%. Logistic regression anal-ysis showed that the basic disease, elderly age, stone shape, size, operation time, perfusion pressure and perfusion vol-ume, postoperative bleeding were the risk factors for postoperative infect ion（P 〈 0 .0 5 ） . Conclusion Percutaneous nephrolithotomy has a high incidence of concurrent infection. Therefore, it is necessary to evaluate the basic condition and the condition of calculus before the operation, and to get ready for the prevention and treatment of the basic dis-ease and decl ine the intraoperative perfusion pressure and reduce the operation time as much as possible. Antibiotics in the preoperative, intraoperative and postoperative are used to reduce postoperative infection.

关 键 词：经皮肾镜碎石取石术 感染 危险因素 预防 

分 类 号：R691.4[医药卫生—泌尿科学]