| 输尿管镜钬激光碎石术后尿源性脓毒血症的危险因素分析 |
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| 引用本文： | 伍宏亮. 输尿管镜钬激光碎石术后尿源性脓毒血症的危险因素分析[J]. 中华全科医学, 2016, 14(12): 2031-2033. DOI: 10.16766/j.cnki.issn.1674-4152.2016.12.018 |
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| 作者姓名： | 伍宏亮 |
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| 作者单位： | 蚌埠医学院第一附属医院泌尿外科, 安徽 蚌埠 233004 |
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| 摘 要： | 目的 探讨经输尿管镜钬激光碎石术术后尿源性脓毒血症发生的危险因素。 方法 回顾性分析2011年6月—2015年6月399例行输尿管镜钬激光碎石术的输尿管结石患者的临床资料。收集患者年龄、性别、术前尿培养阳性率、糖尿病、息肉有无、结石大小和手术时间等临床资料，术后23例(5.76%)发生尿源性脓毒血症，男性9例，女性14例(11例处于围绝经期)，年龄39～78岁，平均(50.8±16.5)岁；手术时间47～197 min，平均(62.8±23.5) min；术前尿培养阳性16例，其中革兰氏阴性菌大肠埃希菌11例、肺炎克雷伯菌2例，革兰氏阴性菌金黄色葡萄球菌2例、表皮葡萄球菌1例；均未输血。采用单因素分析和Logistic回归分析法分析术后发生尿源性脓毒血症的危险因素。 结果 单因素分析结果显示，高龄(≥70岁)、女性、糖尿病、术前尿培养阳性及手术时间＞60 min与尿源性脓毒血症的发生有关(均P＜0.05)，而结石大小、息肉有无与尿源性脓毒血症发生无关(均P＞0.05)；Logistic回归分析结果显示，女性、糖尿病、术前尿培养阳性及手术时间长与尿源性脓毒血症的发生相关(均P＜0.05)。 结论 女性、糖尿病、术前尿培养阳性及手术时间长是输尿管镜钬激光碎石术术后发生尿源性脓毒血症的独立危险因素。
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| 关 键 词： | 输尿管镜 结石 尿源性脓毒血症 危险因素 |
| 收稿时间： | 2016-04-27 |
Risk factors of urosepsis after ureteroscopy with holmium laser lithotripsy |
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| Affiliation: | Department of Urology Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China |
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| Abstract: | Objective To study the risk factors of urosepsis after ureteroscopy with holmium laser lithotripsy. Methods The clinical characteristics(age,gender,rate of positive urine culture before the operation,diabetes mellitus,polyp,diameter of stone,and operation time) of 399 ureteral calculus patients undergoing ureteroscopic holmium laser lithotripsy in our hospital between June,2011 and June,2015 were retrospectively analyzed.Among them,23(5.76%) suffered urosepsis.There were 14 female patients(11 cases were in perimenopausal stage) and 9 male patients.The mean age was 50.8±16.5 years(range 39-78 years).The mean operative time was 62.8±23.5 min(range 47-197 min).The urine culture of 16 patients were positive,including gram-negative bacteria Escherichia coli in 11 cases,Klebsiella pneumonia in 2 cases,gram-negative bacteria staphylococcus aureus in 2 cases and staphylococcus epidermidis in 1 case.All patients need not blood transfusion.The chi-square test and a logistic regression model were used to identify key risk factors. Results In univariate analysis,the significant associations were observed between advanced age(≥ 70 years),female gender,diabetes,positive urine culture,operative duration>60 min and sepsis after ureteroscopic holmium laser lithotripsy(all P<0.05).But polyp and stone diameter were insignificant for urosepsis(both P>0.05).While in multivariate analysis,female gender,diabetes,positive urine culture,operative duration>60 min were identified as independent risk factors for urosepsis after ureteroscopy with holmium laser lithotripsy(all P<0.05). Conclusion Female gender,diabetes,positive urine culture,operative duration>60 min are the key risk factors of urosepsis after ureteroscopy with holmium laser lithotripsy. |
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