输尿管上段结石经皮肾镜取石术后感染的危险因素分析  

Risk factors of infection after percutaneous nephrolithotomy for upper ureteral calculi

作　　者：王健[1] 刘华伟[1] 王战豪 Wang Jian;Liu Huawei;Wang Zhanhao(Clinical Laboratory,the Third People's Hospital of Chengdu,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院检验科,成都610031

出　　处：《中国医学前沿杂志（电子版）》2021年第3期134-137,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨输尿管上段结石经皮肾镜取石术后发生感染的病原菌特征和危险因素。方法选取2015年5月至2018年5月成都市第三人民医院收治的输尿管上段结石并行经皮肾镜取石术的646例患者为研究对象。术后收集所有患者中段尿液,对尿液中的病原菌进行分离鉴定,采用多因素Logistic回归分析探讨输尿管上段结石患者经皮肾镜取石术后发生感染的危险因素。结果646例患者中50例发生术后感染,感染率为7.74%。50例感染患者共检出病原菌156株,其中革兰氏阴性菌占比最高,为77.6%,其次为革兰氏阳性菌(21.8%)和真菌(0.6%)。多因素Logistic回归分析结果显示,高龄、手术时间长、合并糖尿病、结石直径大均为输尿管上段结石患者经皮肾镜取石术后发生感染的危险因素(均P<0.05)。结论输尿管上段结石患者经皮肾镜取石术后感染病原菌以革兰氏阴性菌为主。高龄、手术时间长、合并糖尿病、结石直径大均为引起输尿管上段结石患者经皮肾镜取石术后发生感染的危险因素,医护人员应实施有针对性的防控措施以预防感染。Objective To investigate the pathogenic characteristics and risk factors of infection after percutaneous nephrolithotomy for upper ureteral calculi.Method A total of 646 patients with upper ureteral calculi admitted to the Third People's Hospital of Chengdu from May 2015 to May 2018 and underwent percutaneous nephrolithotomy were selected as subjects.All patients'mid stream urine was collected postoperatively,and the pathogenic bacteria in urine were isolated and identified.Multivariate Logistic regression analysis was used to investigate the risk factors of infection in patients with upper ureteral calculi after percutaneous nephrolithotomy.Result Postoperative infection occurred in 50 of the 646 patients,with an infection rate of 7.74%.A total of 156 strains of pathogenic bacteria were detected in 50 patients,among which the composition ratio of Gram-negative bacteria was the highest(77.6%),followed by Gram-positive bacteria(21.8%)and fungi(0.6%).Multivariate Logistic regression analysis showed that advanced age,long operation time,diabetes mellitus and large stone diameter were risk factors for infection in patients with upper ureteral calculi after percutaneous nephrolithotomy(all P<0.05).Conclusion Gram-negative bacteria were the main pathogenic bacteria after percutaneous nephrolithotomy for patients with upper ureteral calculi.Advanced age,long operation time,diabetes mellitus,and large stone diameter are risk factors for infection in patients with upper ureteral calculi after percutaneous nephrolithotomy.Therefore,medical staff should implement targeted prevention and control measures to prevent infection.

关 键 词：输尿管上段结石 经皮肾镜取石术 感染 病原菌 危险因素 

分 类 号：R699.4[医药卫生—泌尿科学]