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影响软性输尿管镜检查后感染性并发症的因素。

Factors affecting infectious complications following flexible ureterorenoscopy.

机构信息

Urology Department, Haseki Training and Research Hospital, Millet Street, Fatih, Istanbul, Turkey.

出版信息

Urolithiasis. 2019 Oct;47(5):481-486. doi: 10.1007/s00240-018-1098-y. Epub 2018 Nov 17.

Abstract

In the present study, we aimed to clarify predictive factors that may cause postoperative infectious complications after flexible ureterorenoscopy (f-URS). In a 4-year prospective study, charts of patients who underwent f-URS between January 2014 and January 2018 for renal stone(s) in a tertiary academic center were reviewed. A standardized f-URS procedure was performed for all patients. Post-operative infectious complications including fever, sepsis and septic shock were categorized into same group. Patients with and without infectious complications were compared in the terms of preoperative, operative and post operative characteristics. In total, 463 patients who did not face infectious complications and 31 patients who faced infectious complications were enrolled into the study. The mean age was significantly lower in patients who did face infectious complications (34.8 vs 44.7 years old, p < 0.001). On the other hand, presence of renal abnormality was significantly more common in patients with infectious complications (12.3% vs 35.5%, p < 0.001). The mean operation time was 65.3 min in patients with infectious complications and significantly longer when compared with patients who did not face infectious complication (47.8 min, p < 0.001). Stone-free rate was significantly higher in patients without infectious complications (85.3% vs 77.5, p = 0.009). Multivariate regression analysis revealed that longer operation time ≥ 60 min, presence of renal abnormality and age ≤ 40 years were predictive factors for infectious complications following f-URS. The present study has demonstrated that operation time ≥ 60 min, presence of renal abnormality and patients with ≤ 40 years were significantly associated with infectious complications following f-URS.

摘要

在本研究中,我们旨在阐明可能导致软性输尿管镜检查(f-URS)后术后感染并发症的预测因素。在一项为期 4 年的前瞻性研究中,回顾了 2014 年 1 月至 2018 年 1 月期间在一家三级学术中心因肾结石接受 f-URS 的患者的病历。所有患者均采用标准化的 f-URS 程序。术后感染性并发症,包括发热、脓毒症和感染性休克,归入同一组。比较了有和没有感染性并发症的患者的术前、术中及术后特征。共纳入 463 例无感染性并发症患者和 31 例有感染性并发症患者。有感染性并发症的患者年龄明显低于无感染性并发症的患者(34.8 岁 vs 44.7 岁,p<0.001)。另一方面,有肾异常的患者在有感染性并发症的患者中更为常见(12.3% vs 35.5%,p<0.001)。有感染性并发症的患者的平均手术时间为 65.3 分钟,明显长于无感染性并发症的患者(47.8 分钟,p<0.001)。无感染性并发症患者的结石清除率明显较高(85.3% vs 77.5%,p=0.009)。多变量回归分析显示,手术时间≥60 分钟、存在肾异常和年龄≤40 岁是 f-URS 后发生感染并发症的预测因素。本研究表明,手术时间≥60 分钟、存在肾异常和年龄≤40 岁与 f-URS 后感染并发症显著相关。

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