经皮肾镜取石术：术后首日之后发热及全身炎症反应综合征的相关因素

Percutaneous nephrolithotomy: factors associated with fever after the first postoperative day and systemic inflammatory response syndrome.

作者信息

Draga Ronald O P, Kok Esther T, Sorel Marique R, Bosch Ruud J L H, Lock Tycho M T W

机构信息

Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

J Endourol. 2009 Jun;23(6):921-7. doi: 10.1089/end.2009.0041.

DOI:10.1089/end.2009.0041

PMID:19473071

Abstract

OBJECTIVE

Fever after the first postoperative day (POD1) after percutaneous nephrolithotomy (PCNL) is most likely caused by an infection that increases hospital stay and healthcare costs. The aim of this study was to find factors associated with fever after POD1 and systemic inflammatory response syndrome (SIRS).

PATIENTS AND METHODS

Ninety patients underwent 117 PCNLs. Patient characteristics, stone burden, and pre- and postoperative treatments were analyzed for association with fever (temperature >or=38 degrees C) and SIRS using univariate analysis.

RESULTS

In 35% of the patients with fever (temperature >or=38 degrees C), fever was present after POD1. Twelve patients developed signs of SIRS (11.2%). In univariate analysis, significant association was observed between fever after POD1 and previous ipsilateral PCNL (p = 0.022, odds ratio OR = 3.1), and between SIRS and paraplegia (p = 0.005, OR = 10.7) and caliceal stones (p = 0.03, OR = 4.8).

CONCLUSIONS

Previous ipsilateral PCNL increases the risk of fever after POD1. Paraplegic patients are at risk for developing SIRS after PCNL.

摘要

目的

经皮肾镜取石术（PCNL）术后第一天（POD1）后出现发热最可能是由感染引起的，这会延长住院时间并增加医疗费用。本研究的目的是找出与POD1后发热及全身炎症反应综合征（SIRS）相关的因素。

患者与方法

90例患者接受了117次PCNL手术。采用单因素分析对患者特征、结石负荷以及术前和术后治疗与发热（体温≥38摄氏度）和SIRS的相关性进行分析。

结果

在35%发热（体温≥38摄氏度）的患者中，发热出现在POD1之后。12例患者出现SIRS体征（11.2%）。在单因素分析中，观察到POD1后发热与既往同侧PCNL之间存在显著相关性（p = 0.022，比值比OR = 3.1），SIRS与截瘫（p = 0.005，OR = 10.7）和肾盂结石（p = 0.03，OR = 4.8）之间存在显著相关性。