输尿管硬镜治疗上尿路结石术后并发泌尿系统感染的危险因素分析  

Risk factors of urinary tract infection after rigid ureteroscopy for upper urinary tract calculi

作　　者：胡生银[1] Hu Shengyin(Department of Urology Surgery,the Fifth People's Hospital of Datong,Datong 037600,China)

机构地区：[1]山西省大同市第五人民医院泌尿外科,037600

出　　处：《中国实用医刊》2020年第3期57-59,共3页Chinese Journal of Practical Medicine

摘　　要：目的分析输尿管硬镜治疗上尿路结石术后并发泌尿系统感染的高危因素。方法回顾性分析2017年4月至2018年7月大同市第五人民医院诊治的37例上尿路结石输尿管硬镜治疗术后合并泌尿系感染患者的临床资料。37例患者行输尿管硬镜治疗后,收集其中段清洁尿液,置于无菌管中,立即送检验科细菌室进行细菌培养,详细记录患者年龄、性别、体质指数、结石长径、结石梗阻类型、手术时间及合并糖尿病、高血压等相关基础疾病,分析其与患者发生术后泌尿系统感染的相关性。结果37例输尿管硬镜治疗上尿路结石术后泌尿系感染患者共培养出病原菌64株,以革兰阴性菌为主,且其中的肺炎克雷伯杆菌和大肠埃希菌占主导地位,分别占18.75%(12/64)和35.94%(23/64);革兰阳性菌以金黄色葡萄球菌和粪肠球菌为主,分别占7.81%(5/64)和6.25%(4/64);真菌只有2株,占3.13%。导致输尿管硬镜治疗上尿路结石术后泌尿系感染的危险因素主要有患者年龄、结石长径、结石梗阻类型、合并糖尿病相关基础疾病及手术时间(P<0.05)。结论患者年龄、结石长径、结石梗阻类型、合并糖尿病相关基础疾病及手术时间是输尿管硬镜治疗上尿路结石患者术后泌尿系统感染的高危因素,且病原菌感染以革兰阴性菌为主。Objective To analyze the risk factors of urinary tract infection after rigid ureteroscopy for upper urinary tract calculi.Methods A total of 37 patients with urinary tract infection after rigid ureteroscopy for upper urinary tract calculi who were treated in the Fifth People’s Hospital of Datong from April 2017 to July 2018 were enrolled. After rigid ureteroscopy treatment, cleaned urine samples were collected from the 37 patients by sterile tubes, and were immediately sent to the laboratory bacteria room for bacterial culture. The patient’s age, gender, body mass index, major diameter of stone, type of stone obstruction, operation time, and related basic diseases such as diabetes mellitus and hypertension were recorded in detail. The relationships between the above factors and postoperative urinary tract infection were analyzed.Results A total of 64 pathogenic bacteria were cultured in 37 patients with urinary tract infection after rigid ureteroscopy for upper urinary tract calculi. Most of them were Gram-negative bacteria, of which the Klebsiella pneumoniae and Escherichia coli were dominant, accounting for 18.75% (12/64) and 35.94% (23/64) respectively. Among Gram-positive bacteria, Staphylococcus aureus and Enterococcus faecalis were the predominant types, accounting for 7.81% (5/64) and 6.25%(4/64), respectively. There were only 2 strains of fungi, accounting for 3.13%. The risk factors of urinary tract infection after rigid ureteroscopy for upper urinary tract calculi were age, major diameter of stone, type of stone obstruction, diabetes mellitus and operation time (P<0.05).Conclusions Age, major diameter of stone, type of stone obstruction, diabetes mellitus and operative time are risk factors of urinary tract infection in patients with upper urinary tract calculi treated by rigid ureteroscopy. And the major pathogenic bacteria of the disease are Gram-negative bacteria.

关 键 词：输尿管镜 上尿路结石 感染 高危因素 

分 类 号：R699[医药卫生—泌尿科学]