妊娠期急性肾绞痛输尿管D-J管置入术后泌尿道感染预后因素分析  

Analysis of risk factors for urinary tract infection in pregnant women with acute renal colic after indwelling ureteral D-J tube

作　　者：莫利才[1] 汪佳佳 冯骎 李飞平[1] Mo Licai;Wang Jiajia;Feng Qin;Li Feiping(Department of Urology,Taizhou Hospital of Zhejiang Province,Taizhou 317000,China;Department of Traditional Chinese Medicine,Taizhou Hospital of Zhejiang Province,Taizhou 317000,China)

机构地区：[1]浙江省台州医院泌尿外科,台州317000 [2]浙江省台州医院中医科,台州317000

出　　处：《中华全科医师杂志》2022年第1期53-58,共6页Chinese Journal of General Practitioners

摘　　要：目的探讨妊娠期急性肾绞痛患者输尿管D-J管置入术后与泌尿道感染相关的预后因素。方法收集2008年1月至2019年12月台州恩泽医疗中心(集团)浙江省台州医院及恩泽医院急诊科就诊的妊娠期急性肾绞痛行输尿管D-J管置入治疗的109例患者资料,其中31例(28.4%)在输尿管D-J管置入术后至分娩前发生泌尿道感染者为感染组,78例未发生感染者为非感染组。采用单因素、多因素logistic回归方法分析评估输尿管D-J管置入术后发生泌尿道感染的预后因素。结果109例患者年龄28(25,33)岁[M(Q1,Q3)],孕周26(21,31)周,体重指数24.84(22.60,27.43)kg/m^(2)。与非感染组相比,感染组既往尿培养阳性比例较高[38.7%(12/31)比15.4%(12/78),χ^(2)=6.56,P=0.010],孕周数较低[23(20,28)比27(21,32)周,Mann-WhitneyU检验,P=0.006],有糖尿病病史的比例较高[45.2%(14/31)比11.5%(9/78),χ^(2)=13.86,P<0.001]。多因素logistic回归分析结果显示,糖尿病(OR=7.739,95%CI:2.579~23.223,P<0.001)、既往尿培养阳性(OR=3.249,95%CI:1.131~9.330,P=0.029)、孕周(OR=0.201,95%CI:0.042~0.955,P=0.044)是妊娠期急性肾绞痛输尿管D-J管置入术后发生泌尿道感染的独立预后因素。结论糖尿病病史、既往尿培养阳性、孕周是妊娠期急性肾绞痛输尿管D-J管置入术后发生泌尿道感染的独立预后因素。Objective To investigate the risk factors related to urinary tract infection after indwelling ureteral D-J tube in pregnant women with acute renal colic.Methods Clinical data of 109 pregnant women with acute renal colic undergoing indwelling ureteral D-J tube in emergency department of Taizhou Hospital or Enze Hospital from January 2008 to December 2019 were retrospectively analyzed.There were 31 cases(28.4%)with urinary tract infection after discharge and before delivery(infection group)and 78 cases without infection(non-infected group).Univariate and multivariate logistic regression analyses were used to evaluate the risk factors of urinary tract infection after ureteral D-J tube insertion.Results In 109 patients the average age was 28(25,33)years,the average gestational age was 26(21,31)weeks,and the average body mass index(BMI)was 24.84(22.60,27.43)kg/m^(2).Compared with the non-infected group,the infection group had a higher rate of positive urine culture[38.7%(12/31)vs.15.4%(12/78),χ^(²)=6.56,P=0.010]and diabetes[45.2%(14/31)vs.11.5%(9/78),χ^(²)=13.86,P<0.001],and a lower gestational age[23(20,28)vs.27(21,32)weeks,Mann-Whitney U test,P=0.006].Multivariate analysis showed that diabetes(OR=7.739,95%CI:2.579-23.223,P<0.001),positive urine culture(OR=3.249,95%CI:1.131-9.330,P=0.029),and gestational age(OR=0.201,95%CI:0.042-0.955,P=0.044)were independent risk factors for urinary tract infection in pregnant women with acute renal colic after ureteral D-J tube insertion.Conclusion History of diabetes,gestational age,and positive preoperative urine culture are risk factors for urinary tract infection after ureteral D-J tube insertion in pregnant women with acute renal colic.

关 键 词：肾绞痛 泌尿道感染 孕妇 输尿管D-J管 

分 类 号：R714.258[医药卫生—妇产科学]