经皮肾镜碎石取石术后并发感染危险因素

目的了解患者经皮肾镜碎石取石术后并发感染的危险因素,为预防患者术后感染提供依据。方法选择2010年8月—2013年8月某院住院行经皮肾镜碎石取石术患者96例,对其临床资料进行回顾性分析,对患者术后感染情况、危险因素及分离病原体等进行分析。结果经皮肾镜碎石取石术后,发生感染35例,感染率为36.46%(35/96)。单因素分析结果显示,结石大小、形状、手术时间以及灌注量是患者术后感染的危险因素(均P0.05)。对术前96例患者和术后18例患者进行尿细菌培养,共检出病原菌39株,其中大肠埃希菌占首位(12株),其次为铜绿假单胞菌(8株)、草绿色链球菌(5株)、肺炎克雷伯菌(4株)和阴沟肠杆菌(3株)等。结论经皮肾镜取石术后并发感染率高;进行此类手术时,应做好充足地术前准备,有效减少手术时间和术中灌注量;同时,合理使用抗菌药物,以改善患者术后感染情况。

Risk factors for infection following percutaneous nephrolithotomy

ObjectiveTo explore the risk factors for infection following percutaneous nephrolithotomy(PCNL),and provide the basis for prevention of postoperative infection.Methods96 patients who were performed PCNL in a hospital between August 2010 and August 2013 were chosen, clinical data of patients were retrospectively analyzed, the occurrence of postoperative infection, risk factors and isolated pathogens were analyzed.Results35 patients (36.46%［35/96］）developed infection following PCNL.  Univariate analysis revealed that risk factors for postoperative infection were the size and shape of stone, duration of operation, and intraoperative perfusion (all P<0.05). 96 patients before operation and 18 patients after operation were performed bacterial culture for urine, a total of 39 strains were isolated, the main isolated pathogens was  Escherichia coli (n=12),   followed by Pseudomonas aeruginosa (n=8),  Streptococcus viridans (n=5), Klebsiella pneumoniae (n=4) and Enterobacter cloacae (n=3). ConclusionInfection rate following PCNL is high, duration of operation and intraoperative perfusion should be reduced, antimicrobial agents should be used rationally.