一期输尿管软镜联合钬激光治疗1.5~3.0 cm肾结石术后尿路感染危险因素分析  

Analysis of Risk Factors for Urinary Tract Infection After Primary Ureteroscopy Combined with Holmium Laser Treatment for Kidney Stones(1.5~3.0 cm)

作　　者：何建伟 卢学仁 谭高峰 连天奇 HE Jianwei;LU Xueren;TAN Gaofeng;LIAN Tianqi(Urology Department,Zhumadian Guangji Cardiovascular Hospital,Zhumadian Henan 463000,China)

机构地区：[1]驻马店广济心血管病医院泌尿外科,河南驻马店463000

出　　处：《临床研究》2025年第3期21-24,共4页Clinical Research

摘　　要：目的研究一期输尿管软镜联合钬激光治疗下肾结石(1.5~3.0 cm)患者术后尿路感染的危险因素。方法回顾性选择2020年7月至2024年3月驻马店广济心血管病医院收治的86例肾结石术患者作为研究对象。根据入选者术后是否发生尿路感染对其分组,将发生及未发生尿路感染的患者分别纳入尿路感染组、未尿路感染组,统计两组人数、占比。对比两组一般资料,选择Logistic回归分析有差异项,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)、标准误、最佳界值、敏感度、特异度。结果本次纳入的86例接受输尿管软镜联合钬激光治疗的肾结石(1.5~3.0 cm)患者中,尿路感染者15例(尿路感染组),占比17.44%;未发生尿路感染者71例(未尿路感染组),占比82.56%。两组术前血清降钙素原(PCT)水平、术前6 h C反应蛋白(CRP)/血清白蛋白(ALB)比值、结石负荷、术前6 h血糖水平对比差异均有统计学意义(P<0.05),且上述指标均为患者接受一期输尿管软镜联合钬激光治疗后发生尿路感染的危险因素,各因素对尿路感染均具有较高的预测价值,AUC值分别为0.652、0.654、0.657、0.677,且OR值均>1,AUC值均>0.6。结论存在约17.44%的肾结石(1.5~3.0 cm)患者在接受一期输尿管软镜联合钬激光治疗后易发生尿路感染。而术前6 h PCT水平、术前6 hCRP/ALB值、结石负荷、术前6 h血糖水平均为患者术后尿路感染的独立危险因素,且上述因素对术后尿路感染均具有较高的预测价值。Objective To study the risk factors for urinary tract infection(UTI)in patients after primary ureteroscopy combined with holmium laser treatment for kidney stones measuring 1.5 to 3.0 cm.Methods A retrospective analysis was performed on 86 patients who underwent surgery for kidney stones at Zhumadian Guangji Cardiovascular Hospital from July 2020 to March 2024.Patients were divided into UTI and non-UTI groups based on the occurrence of urinary tract infection after surgery.The number and proportion of patients in each group were recorded.General information was compared between the two groups,and Logistic regression analysis was conducted on items showing differences.Receiver Operating Characteristic(ROC)curves were plotted to calculate the area under the curve(AUC),standard error,optimal cut-off values,sensitivity,and specificity.Results Among the 86 patients who underwent ureteroscopy combined with holmium laser treatment for kidney stones(1.5~3.0 cm),15 patients developed urinary tract infections(UTI group),accounting for 17.44%,while 71 patients did not develop infections(non-UTI group),accounting for 82.56%.The preoperative serum procalcitonin(PCT)levels,the ratio of C-reactive protein(CRP)to serum albumin(ALB)at 6 hours before surgery,stone burden,and blood glucose levels at 6 hours before surgery showed significant differences between the two groups(P<0.05).These indicators were identified as risk factors for the occurrence of urinary tract infections after primary ureteroscopy with holmium laser treatment,with high predictive values for UTI,having AUC values of 0.652,0.654,0.657,and 0.677,respectively,and all OR values were>1,and all AUC values were>0.6.Conclusion About 17.44%of patients with kidney stones(1.5~3.0 cm)are at increased risk of urinary tract infections following primary ureteroscopy combined with holmium laser treatment.Preoperative PCT levels at 6 hours,CRP/ALB ratios at 6 hours,stone burden,and blood glucose levels at 6 hours before surgery are independent risk factors for postoperative ur

关 键 词：一期输尿管软镜 钬激光 肾结石 尿路感染 

分 类 号：R699.2[医药卫生—泌尿科学]