上尿路结石经输尿管软镜碎石术后并发全身炎症反应综合征的临床特征和危险因素分析

目的探讨上尿路结石患者经输尿管软镜碎石术(FURL)后并发全身炎症反应综合征(SIRS)的临床特征和危险因素。方法︰回顾性选取2018年1月—2020年10月宿州市第一人民医院收治的FURL治疗上尿路结石患者157例,分析患者的治疗结果和并发症发生情况。根据患者是否并发SIRS将其分为SIRS组(n=31)和非SIRS组(n=126),对两组患者的临床资料进行单因素分析,将差异具有统计学意义的因素纳入LASSO-Logistice回归分析模型,通过Nomogram对模型进行可视化处理,并对模型的区分度和准确度进行验证评价。结果单因素分析结果显示,性别(P=0.O10),结石平均大小(P<0.05),术前尿白细胞计数(P<0.05),手术时间(P<0.05)和术后结石细菌培养(P<0.05)在两组患者间差异均具有统计学意义。LASSO-Logistic回归分析结果显示,以上因素均为患者并发SIRS的独立危险因素,根据上述危险因素构建的Nomogram并发SIRS风险预测模型区分度好,与实际观测值的一致性较高。结论女性、结石较大、术前尿白细胞计数高、手术时间较长、术后结石细菌培养为阳性为上尿路结石患者FURL后并发SIRS的独立危险因素。

Clinical features and risk factors of systemic inflammatory response syndrome after flexible ureteroscopic lithotripsy with upper urinary tract stones

Objective To explore the elinicpl features and risk factors of systermic inflammatory responsessyndrome(SIRS)after flexible ureteroscopic lithotripsy(FURL.)with upper urinary tract stones.MethodsA retrospective of 157 patients with upper urinary calculi treated by FURL who were admnitted to Suzhou FirstPeople's Hospital from January 2018 to Oetober 2020 were selected to analyze the treatment results andcomplications of the patients.Patients were divided into SIRS group(n=31)and non-SIRS group(n=126)according to whether they were complicated by SIRS.The clinical data between the two groups were analyzed by asingle factor,and the factors with statistical significance were included in the L.ASSO-Logistic regression analysis.Visualize the model through the Nomogram,and verify and evaluate the discrimination and accuracy of the model.Results The results of univariate analysis showed that gender(P=0.010),average stone size(P<0.05),preoperative urine white blood cell count(P<0.05),operation time(P<0.05)and postoperative stone bacterialculture(P<0.05)were different between the two groups and the differences were statistically significant.TheLASSO-Logistic regression analysis results show that the above factors were all independent risk factors for patientswith SIRS.The Nomogram complicated SIRS risk prediction model constructed based on the above risk factors hasgood discrimination and high consistency with actual observations.Conclusion Females,large stones,highpreoperative white blood cell counts,longer operation time,and positive bacterial culture of postoperative stones areindependent risk factors for SIRS after FURL in patients with upper urinary calculi.