非手术因素输尿管结石继发尿源性脓毒血症的临床研究  

Clinical Study of Secondary Urinary Sepsis in Ureteral Calculi with Non-operative Factor

作　　者：陈清升 甘斯琴 欧阳晨思 吴敏红 胡劲 CHEN Qingsheng;GAN Siqin;OUYANG Chensi;WU Minhong;HU Jin(Yichun People's Hospital,Jiangxi Province,Yichun 336000,China)

机构地区：[1]江西省宜春市人民医院,江西宜春336000 [2]江西省宜春市第二人民医院

出　　处：《中国医学创新》2023年第19期169-173,共5页Medical Innovation of China

基　　金：宜春市科技计划项目(2022ZDJH6209)。

摘　　要：目的:探究输尿管结石继发尿源性脓毒血症的非手术影响因素。方法:回顾性分析2019年11月—2022年12月在宜春市人民医院进行治疗的90例输尿管结石患者临床资料,依据是否继发尿源性脓毒血症分成休克组(n=30)与非休克组(n=60),比较两组年龄、性别、基础疾病、肥胖、结石疼痛时间、病原菌、血白细胞(WBC)、血小板、降钙素原(PCT)、乳酸(Lac)、白蛋白、C反应蛋白(CRP)、处理方法、结石类型等临床资料,将具有统计学意义的临床指标纳入多因素logistic回归分析中得到输尿管结石患者的非手术影响因素。结果:休克组女性占比、糖尿病占比、大肠埃希菌占比、WBC水平、PCT水平、Lac水平、CRP水平均高于非休克组,血小板计数、白蛋白水平均低于非休克组,差异均有统计学意义(P<0.05),经logistic回归分析,结果显示女性、合并糖尿病、大肠埃希菌感染、高水平WBC、高水平血小板计数、高水平PCT、高水平Lac、低水平白蛋白、高水平CRP为输尿管结石患者继发尿源性脓毒血症的非手术独立危险因素(P<0.05)。结论:输尿管结石患者继发尿源性脓毒血症与多种非手术因素局有限相关性,其中女性、合并糖尿病、感染大肠埃希菌、高水平WBC、血小板计数、PCT、Lac与CRP,低水平白蛋白水平为尿源性脓毒血症发生的独立危险因素,临床应针对上述各项危险因素予以干预措施。Objective:To explore the non-operative influencing factors of urinary sepsis secondary to ureteral calculi.Method:The clinical data of 90 patients with ureteral calculi who underwent surgical treatment in Yichun People's Hospital between November 2019 and December 2022 were analyzed retrospectively.According to the presence or absence of secondary urinary sepsis,the patients were divided into shock group(n=30)and non-shock group(n=60).The age,gender,underlying disease,obesity,duration of stone induced pain,pathogen,white blood cell(WBC),platelet,procalcitonin(PCT),lactic acid(Lac),albumin,C reactive protein(CRP),treatment method and type of stone were compared between two groups.Multivariate logistic regression analysis was performed to screen the non-operative influencing factors.Result:The proportion of females,proportion of patients with diabetes,proportion of Escherichia coli,WBC,PCT level,Lac level and CRP level in the shock group were higher than those in the non-shock group,platelet count and albumin level were lower than those in the non-shock group,the differences were statistically significant(P<0.05).logistic regression analysis found that female,diabetes,Escherichia coli infection,high WBC,high platelet count,high PCT level,high Lac level,low albumin level and high CRP level were non-operative independent risk factors of secondary urinary sepsis in patients with ureteral calculi(P<0.05).Conclusion:Secondary urinary sepsis is correlated with many non-operative factors in patients with ureteral calculi.Female gender,diabetes mellitus,Escherichia coli infection,high levels of WBC,platelet count,PCT,Lac and CRP,and low level of albumin are independent risk factors of secondary urinary sepsis.Clinically,intervention measures should be taken according to the above risk factors.

关 键 词：输尿管结石 尿源性脓毒血症 非手术因素 基础疾病 病原菌 

分 类 号：R459.7[医药卫生—急诊医学] R693.4[医药卫生—治疗学]