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肾结石逆行性肾内手术后发热性尿路感染的危险因素。

Risk factors of febrile urinary tract infections following retrograde intrarenal surgery for renal stones.

机构信息

Department of Urology, School of Medicine, Kyung Hee University.

出版信息

Medicine (Baltimore). 2021 Apr 2;100(13):e25182. doi: 10.1097/MD.0000000000025182.

Abstract

We aimed to evaluate the risk factors of febrile urinary tract infection (UTI) following retrograde intrarenal surgery (RIRS) for treating renal stones.We retrospectively reviewed the data of patients with 10 - 30 mm kidney stones who underwent RIRS from January 2014 to July 2017. Evaluation included age, gender, body mass index, stone size, stone location, and operative time. All surgeries were performed by a single surgeon and ureteral stenting was not done prior surgery. The risk factors of febrile UTI after RIRS were assessed by univariate and multivariate logistic regression analysis.A total of 150 patients were included in the present study, and 17 patients (11.3%) had febrile UTI after RIRS. Mean patient age was 56.64 ± 13.91 years, and both genders were evenly distributed. Mean stone size was 14.16 ± 5.89 mm. and mean operation time was 74.50 ± 42.56 minutes. According to univariate analysis, preoperative pyuria was associated with postoperative febrile UTI. Multivariate logistic regression analysis showed that preoperative pyuria was the only independent risk factor of infectious complications after RIRS (odds ratios 8.311, 95% confidence intervals 1.759 - 39.275, P = .008). Age, gender, body mass index, comorbidity, preoperative bacteriuria, presence of hydronephrosis, renal stone characteristics, and operative time were not associated with febrile UTI after RIRS.Preoperative pyuria was the only risk factor of infectious complications following RIRS. Therefore, careful management after RIRS is necessary especially when preoperative urinalysis shows pyuria.

摘要

我们旨在评估逆行性肾内手术(RIRS)治疗肾结石后发热性尿路感染(UTI)的危险因素。我们回顾性分析了 2014 年 1 月至 2017 年 7 月接受 RIRS 治疗的 10-30mm 肾结石患者的数据。评估包括年龄、性别、体重指数、结石大小、结石位置和手术时间。所有手术均由同一位外科医生进行,术前不进行输尿管支架置入。通过单因素和多因素 logistic 回归分析评估 RIRS 后发热性 UTI 的危险因素。本研究共纳入 150 例患者,17 例(11.3%)患者在 RIRS 后出现发热性 UTI。患者平均年龄为 56.64±13.91 岁,性别分布均匀。平均结石大小为 14.16±5.89mm,平均手术时间为 74.50±42.56 分钟。根据单因素分析,术前脓尿与术后发热性 UTI 相关。多因素 logistic 回归分析显示,术前脓尿是 RIRS 后感染性并发症的唯一独立危险因素(比值比 8.311,95%置信区间 1.759-39.275,P=0.008)。年龄、性别、体重指数、合并症、术前菌尿、肾盂积水、肾结石特征和手术时间与 RIRS 后发热性 UTI 无关。术前脓尿是 RIRS 后感染性并发症的唯一危险因素。因此,RIRS 后需要特别注意管理,尤其是术前尿液分析显示脓尿时。

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