小儿肾积水腹腔镜肾盂输尿管成形术后发生尿路感染的影响因素  

Influencing factors of urinary tract infection after laparoscopic Pyeloureteroplasty in children with hydronephrosis

作　　者：张前进 杨艳芳 ZHANG Qianjin;YANG Yanfang(Urology Department,Women's and Children's Hospital,Zhumadian City Center Hospital,Zhumadian 463000 Henan,China)

机构地区：[1]驻马店市中心医院妇儿院区泌尿外科,河南驻马店463000

出　　处：《中国民康医学》2023年第23期1-4,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:分析小儿肾积水腹腔镜肾盂输尿管成形术后发生尿路感染的影响因素。方法:选取2021年5月至2023年5月该院收治的130例行腹腔镜肾盂输尿管成形术的肾积水患儿进行前瞻性研究,统计小儿肾积水腹腔镜肾盂输尿管成形术后尿路感染发生情况,采用Logistic回归分析小儿肾积水腹腔镜肾盂输尿管成形术后发生尿路感染的影响因素。结果:130例小儿肾积水腹腔镜肾盂输尿管成形术后发生尿路感染32例,发生率为24.62%(32/130),设为发生组,其余设为未发生组;发生组分肾功能<40%、有吻合口张力、重度肾积水、肾实质厚度≥4 mm、内置管、C反应蛋白≥32 mg/dL、血尿素氮≥9 mmol/L、肌酐≥81μmol/L、肾小球滤过率≥23.86 mL/min、胱抑素C≥1.45 mg/L、手术时间≥130 min、术中出血量≥8 mL占比均高于未发生组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,分肾功能<40%、有吻合口张力、肾小球滤过率<23.86 mL/min、胱抑素C≥1.45 mg/L、手术时间≥130 min均为影响小儿肾积水腹腔镜肾盂输尿管成形术后发生尿路感染的危险因素(OR>1,P<0.05)。结论:分肾功能<40%、有吻合口张力、肾小球滤过率<23.86 mL/min、胱抑素C≥1.45 mg/L、手术时间≥130 min均为影响小儿肾积水腹腔镜肾盂输尿管成形术后发生尿路感染的危险因素。Objective:To analyze influencing factors of urinary tract infection after laparoscopic pyeloureteroplasty in children with hydronephrosis.Methods:A prospective study was conducted on 130 children with hydronephrosis who underwent laparoscopic pyeloureteroplasty in this hospital from May 2021 to May 2023.The incidence of urinary tract infection after laparoscopic pyeloureteroplasty in the children with hydronephrosis was statistically analyzed.Logistic regression was used to analyze the influencing factors of urinary tract infection after laparoscopic pyeloureteroplasty in the children with hydronephrosis.Results:32 cases of urinary tract infection occurred after laparoscopic pyeloureteroplasty in the 130 children with hydronephrosis with an incidence rate of 24.62%(32/130).They were set as the occurrence group,while the rest were set as the non-occurrence group.The proportions of the cases of renal function<40%,anastomotic tension,severe hydronephrosis,renal parenchymal thickness≥4 mm,cannula insertion,C-reactive protein≥32 mg/dL,blood urea nitrogen≥9 mmol/L,creatinine≥81μmol/L,glomerular filtration rate≥23.86 mL/min,cystatin C≥1.45 mg/L,surgical time≥130 min,and intraoperative bleeding≥8 mL in the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05).The Logistic regression analysis showed that renal function<40%,anastomotic tension,glomerular filtration rate<23.86 mL/min,cystatin C≥1.45 mg/L,and surgery time≥130 min were all risk factors for urinary tract infection after laparoscopic pyeloureteroplasty in the children with hydronephrosis(OR>1,P<0.05).Conclusions:Renal function<40%,anastomotic tension,glomerular filtration rate<23.86 mL/min,cystatin C≥1.45 mg/L,and surgery time≥130 min are the risk factors for urinary tract infection after laparoscopic pyeloureteroplasty in the children with hydronephrosis.

关 键 词：小儿肾积水 腹腔镜 肾盂输尿管成形术 尿路感染 影响因素 

分 类 号：R619[医药卫生—外科学]