术前中段尿、术中肾盂尿及上尿路结石细菌培养结果与PCNL术后SIRS的相关性  

Correlation between preoperative mid-segment urine,intraoperative pelvic urine and upper urinary tract calculi specimen bacterial culture and SIRS after PCNL

作　　者：胡春勇 陈志健 陈宏辉 钟斌 潘奕能 Hu Chunyong;Chen Zhijian;Chen Honghui;Zhong Bin;Pan Yineng(Department of Urology,Wuzhou Peoples Hospital,Wuzhou 543000,China)

机构地区：[1]梧州市人民医院泌尿外科,梧州543000

出　　处：《国际泌尿系统杂志》2023年第5期836-840,共5页International Journal of Urology and Nephrology

基　　金：梧州市科技计划项目(201902186)。

摘　　要：目的扶探讨术前中段尿、术中肾盂尿及上尿路结石标本细菌培养结果与经皮肾镜碎石术(PCNL)术后发生全身炎症反应综合征(SIRS)的相关性。方法选取2019年1月至2021年7月在本院住院治疗的125例行PCNL手术的患者作为研究对象。根据术后是否发生SIRS将患者分为SIRS组(29例)和非SIRS组(96例)。采用单因素和多因素分析比较两组患者术前中段尿、术中肾盂尿及上尿路结石标本细菌培养结果及与术后SIRS的相关性。结果术前中段尿细菌培养阳性32例,术中肾盂尿细菌培养阳性22例,上尿路结石标本细菌培养阳性46例,38例患者术后24h内发生SIRS。上尿路结石标本细菌培养阳性率显著高于术前中段尿和术中肾盂尿细菌培养阳性率(均P<0.05)。术前中段尿、术中肾盂尿细菌培养阳性和阴性患者的SIRS发生率比较,差异均无统计学意义(均P>0.05)。相比于术前中段尿细菌培养阴性患者,上尿路结石细菌培养阳性患者的SIRS发生率更高(P<0.001)。单因素分析结果显示,SIRS组的女性比例、结石负荷、C反应蛋白(CRP)、降钙素原(PCT)、鹿角型结石、手术时间、术中出血量高于非SIRS组,而术前血肌酐、术前白细胞低于非SIRS组,差异均有统计学意义(均P<0.001)。多因素logistic回归分析结果显示,PCT、上尿路结石细菌培养、鹿角型结石是行PCNL患者术后发生SIRS的危险因素(均P<0.05)。结论PCT、上尿路结石细菌培养、鹿角型结石是行PCNL患者术后发生SIRS的危险因素,围手术期应密切关注这些指标,及时作出相应的干预措施,以提高手术安全性。Objective To investigate the correlation between the results of bacterial culture of preoperative mid-segment urine,intraoperative pyeluria and upper urinary tract calculi specimens and systemic inflammatory response syndrome(SIRS)after percutaneous nephrolithotripsy(PCNL).Methods A total of 125 patients undergoing PCNL surgery who were hospitalized in our hospital from January 2019 to July 2021 were selected as the research subjects.The patients were divided into SIRS group(29 cases)and non-SIRS group(96 cases)according to whether they developed SIRS after operation.The bacterial culture results of preoperative mid-segment urine,intraoperative renal pelvic urine and upper urinary tract calculi specimens and their correlation with postoperative SIRS were compared between the two groups,and univariate and multivariate analyses were performed.Results Preoperative mid-segment urine bacterial culture was positive in 32 cases,intraoperative renal pelvis urine bacterial culture was positive in 22 cases,upper urinary tract calculi specimens were positive in bacterial culture in 46 cases,and 38 patients developed SIRS within 24 hours after operation.The positive rate of bacterial culture in upper urinary tract calculi specimens was significantly higher than that of preoperative mid-segment urine bacterial culture and intraoperative renal pelvic urine bacterial culture positive rate(all P<0.05).There was no significant difference in the incidence of SIRS between the patients with positive mid-segment urine bacterial culture before surgery and the patients with negative mid-segment urinary bacterial culture before surgery(all P>0.05).he incidence of SIRS was higher in patients with positive upper urinary calculus culture than in patients with negative middle urinary bacteria culture before operation(P<0.001).Univariate analysis showed that the proportion of women,stone load,C-reactive protein(CRP),procalcitonin(PCT),antler stone,operative time and intraoperative blood loss in SIRS group were higher than those in non-SIRS g

关 键 词：肾造口术 经皮 全身炎症反应综合征 细菌培养 

分 类 号：R699[医药卫生—泌尿科学]