年龄对肾盂成形术后行双J管引流患儿围术期泌尿系感染的影响分析  

Influence of age on perioperative urinary tract infection in children with double J tube drainage after laparoscopic pyeloplasty

作　　者：张晨捷 张一帆 李龙 郝春生[1] Zhang Chenjie;Zhang Yifan;Li Long;Hao Chunsheng(Department of Urology,Children's Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院泌尿外科,北京100020 [2]中国医学科学院北京协和医学院研究生院

出　　处：《北京医学》2021年第7期601-603,607,共4页Beijing Medical Journal

摘　　要：目的探讨年龄因素对腹腔镜下肾盂成形术后行双J管引流的患儿发生泌尿系感染的影响。方法选取2012年8月至2020年1月首都儿科研究所附属儿童医院行腹腔镜肾盂成形术的单侧肾盂输尿管连接处梗阻患儿128例。根据术后引流方式不同,分为双J管组(76例)和外支架组(52例);根据入组时患儿年龄又将双J管组患儿分为A组(≤1岁,48例)和B组(>1岁,28例)。分别对双J管组和外支架组,以及A组和B组患儿术后2周泌尿系感染的发生率进行对比。结果双J管组围术期泌尿系感染发生率为38.2%,高于外支架组的7.7%,差异有统计学意义(P<0.01);置入双J管的患儿中,A组围术期泌尿系感染的发生率为47.9%,高于B组的21.4%,差异有统计学意义(P<0.05)。结论在小儿腹腔镜下肾盂输尿管成形术后,行双J管引流会使围术期泌尿系感染的发生率升高,且在留置双J管的患儿中,≤1岁患儿的感染发生率远高于>1岁患儿。故为获得更佳的手术效果和远期预后,应对置入双J管的婴儿行预防性抗感染治疗,并严密监测患儿相应的临床表现和实验室检查结果,及时调整治疗方案。Objective To study the influence of age on perioperative urinary tract infection in children with double J tube drainage after laparoscopic pyeloplasty.Methods The study enrolled 128 children received laparoscopic pyeloplasty from August 2012 to January 2020 in Children’s Hospital Affiliated to Capital Institute of Pediatrics.According to the different postoperative drainage methods,the children were divided into two groups,76 cases in double J tube group and 52 cases in external stent group.The children with double J tube drainage were divided into two subgroups,48 cases in subgroup A(≤one year old)and 28 cases in subgroup B(>one year old).The differences on the incidences of urinary tract infection two weeks after operation in two groups and two subgroups were separately compared and analyzed.Results As for the perioperative urinary tract infection,the incidence rate of double J tube group was 38.2%,which was significantly higher than that of the external stent group(7.7%,P<0.01).The incidence rate of perioperative urinary tract infectionin subgroup A was 47.9%,which was significantly higher than that of subgroup B(21.4%,P<0.05).Conclusions After laparoscopic pyeloplasty,double J tube drainage can increase the incidence rates of perioperative urinary tract infection.In children with double J tube drainage,the patients≤one year old have higher incidence rates than those>one year old.In order to obtain a better surgery effect and long term prognosis,preventive anti-infection treatment,close monitoring on clinical symptoms,signs and laboratory tests and timely adjustment on therapy plans are necessary and effective.

关 键 词：腹腔镜下肾盂成形术 双J管 泌尿系感染 年龄 

分 类 号：R726.9[医药卫生—儿科]