经皮肾镜钬激光碎石术全身炎症反应综合征发生的相关因素

目的:探讨经皮肾镜钬激光碎石术全身炎症反应综合征(SIRS)发生的危险因素.方法:经皮肾镜钬激光碎石术276例中21例发生SIRS.对经皮肾镜手术时间、术前有无尿路感染、结石负荷、结石部位、性别、年龄等诸因素与SIRS发生的关系进行分析.结果:手术时间长、术前有尿路感染和结石负荷较大,以及肾结石者,术后SIRS发生率明显增高,而性别、年龄等因素对SIRS发生率无显著影响.结论:由于手术途径及结石等客观因素,经皮肾镜钬激光碎石术后有发生SIRS的可能;术前充分准备,术中规范操作及低压灌注,术后早期诊断治疗,是降低术后SIRS发生的有效途径.

Risk factors in the occurrence of systemic inflammatory response syndrome after Percutaneous nephrolithotripsy with holmium laser

Objective:To investigate a more effective and safer therapeutic strategy,we analysised the risk factors causing postoperative SIRS in Percutaneous nephrolithotripsy with holmium laser.Methods:A retrospective clinical study was performed on 276 patients undergoing Percutaneous nephrolithotripsy with holmium laser.Risk factors such as operative time,urinary tract infection history,stone burden,location of stone,sex and age,were analysised to assess statistical association with the occurrence of postoperative SIRS.Results:Patients with urinary tract infection history,more stone burden,longer duration of operation,and stones in kidney were found to have elevated occurrence of SIRS.Sex and age correlated poorly with the occurrence of SIRS.Conclusions:Stone and operation themselves are potential factors to cause SIRS.Therefore,careful preoperative preparation,corrective manipulation and low pressure irrigation during operation,early diagnosis and treatment postoperatively are the effective ways to decrease the occurrence of SIRS.