经尿道输尿管镜钬激光碎石术后尿路感染调查及其对预后的影响

焦志灵; 徐国良; 李路鹏; 王连渠

doi:10.13201/j.issn.1001-1420.2020.05.003

经尿道输尿管镜钬激光碎石术后尿路感染调查及其对预后的影响

- 河南大学第一附属医院泌尿外科(河南开封, 475001)
基金项目:
河南省卫健委项目(No:201203082)

详细信息

通讯作者: 王连渠,E-mail:wlq92507@126.com

中图分类号: R693

收稿日期: 2018-08-27

Investigation of urinary tract infection after transurethral ureteroscopic holmium laser lithotripsy and its effect on prognosis

- Department of Urology, First Affiliated Hospital of Henan University, Kaifeng, Henan, 475001, China

More Information

Corresponding author: WANG Lianqu, E-mail: wlq92507@126.com

Received Date: 27 August 2018

摘要

摘要: 目的:探究经尿道输尿管镜钬激光碎石术后尿路感染相关情况及其对患者预后的影响。方法:以本院2015年2月~2018年4月行经尿道输尿管镜钬激光碎石术的270例患者为研究对象,统计术后尿路感染率及其病原菌分布情况,单因素及Logistic多因素回归分析术后尿路感染发生的危险因素,并比较尿路感染与否患者术后复发率、预后生活质量情况。结果:术后尿路感染率11.11%,病原菌分布中革兰阴性菌占63.89%;尿路感染组合并糖尿病、术前尿路感染、结石直径≥2 cm、双J管留置时间≥14 d、住院时间≥10 d、结石残留及无抗菌药物预防性应用所占比例均显著大于非尿路感染组(P<0.05);Logistic多因素回归分析发现合并糖尿病、术前尿路感染、双J管留置时间≥14 d、结石残留为术后尿路感染发生独立危险因素(P<0.05),抗菌药物预防性应用为尿路感染保护因素(P<0.05);尿路感染组术后1年结石复发率显著高于非尿路感染组,生活质量评分显著低于非尿路感染组,差异有统计学意义(P<0.05)。结论:经尿道输尿管镜钬激光碎石术后尿路感染病原菌以革兰阴性菌为主,尿路感染可能增加结石复发风险,其危险因素包括合并糖尿病、尿管留置时间长、术前尿路感染等,而抗菌药物预防性应用能减少尿路感染发生。
- 尿路感染 /
- 输尿管镜 /
- 钬激光碎石 /
- 预后
Abstract: Objective: To explore the status of urinary tract infection after transurethral ureteroscopic holmium laser lithotripsy and its effect on prognosis. Method: From February 2015 to April 2018, 270 patients who underwent transurethral ureteroscopic holmium laser lithotripsy in the hospital were selected as the subjects. The rate of postoperative urinary tract infection and distribution of pathogens were statistically analyzed. Univariate and multivariate Logistic analyses were conducted to screen risk factors for postoperative urinary tract infection.The postoperative recurrence rates and quality of life of patients with urinary tract infection and those without were compared. Result: The incidence rate of urinary tract infection after surgery was 11.11%, and Gram-negative bacteriaaccounted for 63.89% of all pathogens.Compared with the non-urinary tract infection group, the proportions of patients with diabetes mellitus, urinary tract infection before surgery, stones diameter ≥ 2 cm, double J tube indwelling time ≥14 days, hospital stay ≥ 10 days, residual stones and patients without prophylactic application of antibacterial agents in the urinary tract infection group were significantly higher in the urinary tract infection group(P<0.05). Multivariate Logistic regression analysis showed that being complicated with diabetes mellitus, preoperative urinary tract infection, double J tube indwelling time ≥ 14 days and residual stones were independent risk factors for urinary tract infection after surgery, while prophylactic use of antibacterial agents was a protective factor. The recurrence rate of stones in the urinary tract infection group within 1 year after surgery was significantly higher than that in the non-urinary tract infection group, and quality of life score was significantly lower than that in the non-urinary tract infection group(P<0.05).Conclusion: Gram-negative bacteria are common pathogens of urinary tract infection after transurethral ureteroscopic holmium laser lithotripsy. Urinary tract infection may increase the risk of recurrent stones. The risk factors includediabetes mellitus, long catheter indwelling timeand preoperative urinary tract infection. Prophylactic use of antibacterial agents can decrease the occurrence of urinary tract infection.
- urinary tract infection /
- ureteroscopy /
- holmium laser lithotripsy /
- prognosis

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