经皮肾镜取石术前尿培养与术后全身炎症反应综合征的关系

目的:探讨经皮肾镜取石术(PCNL)术前中段尿培养与术后全身炎症反应综合征(SIRS)之间的关系。方法:回顾性分析2010年1月~2013年6月应用超声引导下经皮肾镜气压弹道联合超声碎石术治疗患者的临床资料,所有病例术前均常规行中段尿细菌培养和使用抗生素,分析评价术前中段尿培养与术后SIRS之间的关系。结果:纳入分析97例,中段尿培养阳性者20例。PCNL术后发生SIRS者共17例,其中,术前中段尿培养阳性者6例,阴性者11例。中段尿培养阳性患者术后SIRS发生率与阴性者相比,差异无统计学意义(P0.05)。以尿培养来判断SIRS的灵敏度为35.3%。结论:在应用抗生素情况下,PCNL术前中段尿培养同术后SIRS的发生之间无明显相关性,不是有效的预测指标。

Correlations between preoperative mid-stream urine culture and postoperative systemic inflammatory response syndrome of percutaneous nephrolithotomy

Objective： To explore the relationship between preoperative mid-stream urine culture and postoper- ative systemic inflammatory response syndrome （SIRS） of percutaneous nephrolithotomy. Method： A retrospec- tive analysis of patients underwent PCNL from January 2010 to June 2013 was performed. Preoperative mid- stream urine cultures were clone and antibiotics were used in all patients. The relationship between preoperative mid-stream urine culture and postoperative SIRS was evaluated. Result： There were 97 patients in this study. Twenty patients had a positive urine culture and 17 patients developed SIRS. Six patients had a positive culture who developed SIRS later. There was no statistical difference between positive and negative urine culture groups in terms of SIRS （ P 〉0.05）. The sensitivity of using urine culture to determine the onset of SIRS was 35.3%. Conclusion： There is no obvious correlation between preoperative mid-stream urine culture and postoperative SIRS in patients undergoing percutaneous nephrolithotomy when antibiotics used. Positive preoperative urine is not an efficient indicator of predicting SIRS.