老年输尿管结石输尿管镜钬激光碎石术后泌尿系统感染的危险因素分析  

Analysis of the risk factors of urinary system infection after ureteroscopic lithotripsy with holmium laser in elderly patients with ureteral stones

作　　者：肖翠娥[1] 罗娅[2] 周乐友[3] 张苏霞[1] 肖创清[1] 黄志红[1] 鄢义权 XIAO Cui-e;LUO Ya;ZHOU Le-you;ZHANG Su-xia;XIAO Chuang-qing;HUANG Zhi-hong;YAN Yi-quan(Department of Economic Management Section, No.163 Hospital of PLA, Changsha 410003, China;Department of Urology, No.169 Hospital of PLA, Hunan, Hengyang 421002, China;Department of Urology, No.163 Hospital of PLA, Changsha 410003, China)

机构地区：[1]解放军第163医院经管科,长沙410003 [2]解放军第169医院泌尿外科,湖南衡阳421002 [3]解放军第163医院泌尿外科,长沙410003

出　　处：《中国医学前沿杂志（电子版）》2017年第8期150-153,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析老年输尿管结石输尿管镜钬激光碎石术后泌尿系统感染的危险因素。方法回顾性分析2016年1月至2017年1月于解放军第163医院行输尿管镜钬激光碎石术治疗的98例老年输尿管结石患者的临床资料,包括性别、年龄、基础疾病、结石位置、结石直径、手术时间及术前尿白细胞数、发热情况、尿细菌培养情况、预防性使用抗生素情况。将其中38例术后发生泌尿系统感染的患者纳入感染组,余60例患者未发生泌尿系统感染纳入未感染组。比较两组患者的临床资料,分析术后发生泌尿系统感染的危险因素。结果术后泌尿系统感染主要与女性、结石直径≥13 mm、手术时间≥60分钟、术前尿白细胞数≥45个/ml、术前发热及术前尿培养阳性有关(P<0.05);与年龄、结石位置、基础疾病、术前预防性使用抗生素情况无关(P>0.05)。多因素Logistic回归分析显示,术前发热、术前尿培养阳性、手术时间≥60分钟是老年输尿管结石患者术后发生泌尿系统感染的独立危险因素(P<0.05)。结论术前发热、术前尿培养阳性、手术时间≥60分钟是老年输尿管结石患者输尿管镜钬激光碎石术后泌尿系统感染的独立危险因素,临床中应在控制感染的基础上再行手术治疗,缩短手术时间,从而降低术后泌尿系统感染风险。Objective To analyze the risk factors of urinary tract infection after ureteroscopic holmium laser lithotripsy on elderly patients with ureteral calculi.Method Retrospective analyzed the clinical data of98cases of elderly patients underwent ureteroscopic holmium laser lithotripsy for ureteral calculi from January2016to January2017in No.163Hospital of PLA,included gender,age,basic diseases,stone location,stone diameter,operation time and preoperative white blood cell number,fever,urine bacterial culture and antibiotic prophylaxis situation.Among them,38patients with postoperative urinary tract infection were included into infection group,and60patients without urinary tract infection were included into uninfected group.The clinical data of the two groups were compared and the risk factors of urinary tract infection were analyzed.Result The postoperative urinary tract infection were mainly associated with female,stone diameter≥13mm,operation time≥60minutes,preoperative urinary leukocyte number≥45/ml,preoperative fever and preoperative urine culture positive(P<0.05);and the position of the stones,age,basic diseases,prevention of preoperative antibiotics using had no relationship with the postoperative urinary tract infection(P>0.05).Multivariate Logistic regression analysis showed that preoperative fever,preoperative positive urine culture,operation time≥60minutes were the risk factors of urinary system infection after ureteroscopic lithotripsy with holmium laser in elderly patients with ureteral stones.Conclusion Preoperative fever,preoperative positive urine culture and operation time≥60minutes are the independent risk factors of urinary system infection after ureteroscopic lithotripsy with holmium laser in elderly patients with ureteral stones,so in the clinical we should paid more attention to the control of infection,and be careful for the operation time,in order to reduce the risk of urinary tract infection.

关 键 词：输尿管结石 钬激光碎石术 泌尿系统感染 危险因素 

分 类 号：R699.4[医药卫生—泌尿科学]