Ao P, Shu L, Zhuo D, Zhang Z X, Dong C B, Huang H B, Wei Z Q
Department of Urology, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China.
Department of Operating Room, the First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China.
Zhonghua Yi Xue Za Zhi. 2019 Mar 12;99(10):758-763. doi: 10.3760/cma.j.issn.0376-2491.2019.10.010.
To investigate the risk factors of systemic inflammatory response syndrome (SIRS) in patients undergoing flexible ureteroscopic lithotripsy based on enhanced recovery after surgery (ERAS). The clinical data of 243 kidney stone cases who underwent flexible ureteroscopic lithotripsy based on ERAS in the First Affiliated Hospital of Wannan Medical College from January 2016 to December 2017 were analyzed retrospectively. The cases were divided into two groups according to whether they had SIRS after surgery: SIRS group (26 cases) and non-SIRS group (217 cases). The age, gender, laterality of kidney stone, history of previous kidney stone surgery, degree of hydronephrosis, multiple kidney stones, length of operation time, white blood cell count of preoperative urine routine, result of preoperative urine culture, use of preoperative antibiotics, diabetes and other chronic diseases in the groups were collected and analyzed. SIRS occurred in 26 cases in this study, which accounted for 10.7% (26/243). Multivariate analysis found that, moderate and severe hydronephrosis (6.711, 0.008), stone burden ≥2 cm (10.353, 0.001), length of operation time ≥ 60 min (5.583, 0.011), white blood cell count of preoperative urine routine ≥25×10(6)/L (6.195, 0.005), positive preoperative urine culture (4.216, 0.011), diabetes and other chronic diseases (4.532, 0.006) were the independent risk factors for postoperative SIRS (0.05). The occurrence of SIRS after flexible ureteroscopic lithotripsy based on ERAS is closely correlated with hydronephrosis, stone burden, length of operation time, white blood cell count of preoperative urine routine, positive preoperative urine culture, diabetes and other chronic diseases.
基于术后加速康复(ERAS)探究输尿管软镜碎石术患者发生全身炎症反应综合征(SIRS)的危险因素。回顾性分析2016年1月至2017年12月在皖南医学院第一附属医院接受基于ERAS的输尿管软镜碎石术的243例肾结石患者的临床资料。根据术后是否发生SIRS将病例分为两组:SIRS组(26例)和非SIRS组(217例)。收集并分析两组患者的年龄、性别、肾结石患侧、既往肾结石手术史、肾积水程度、多发肾结石、手术时间、术前尿常规白细胞计数、术前尿培养结果、术前抗生素使用情况、糖尿病及其他慢性疾病情况。本研究中26例发生SIRS,占10.7%(26/243)。多因素分析发现,中重度肾积水(6.711,0.008)、结石负荷≥2 cm(10.353,0.001)、手术时间≥60分钟(5.583,0.011)、术前尿常规白细胞计数≥25×10⁶/L(6.195,0.005)、术前尿培养阳性(4.216,0.011)、糖尿病及其他慢性疾病(4.532,0.006)是术后SIRS的独立危险因素(P<0.05)。基于ERAS的输尿管软镜碎石术后SIRS的发生与肾积水、结石负荷、手术时间、术前尿常规白细胞计数、术前尿培养阳性、糖尿病及其他慢性疾病密切相关。