Kumar G Manoj, Nirmal K P, Kumar G Sathish
Department of Urology, Government Medical College, Thiruvananthapuram, Kerala, India.
Urol Ann. 2021 Oct-Dec;13(4):340-345. doi: 10.4103/UA.UA_153_20. Epub 2021 Sep 2.
Percutaneous nephrolithotomy (PCNL) is recommended as the first choice of therapeutic strategy for patients with renal stones larger than 2 cm. It is reported that up to one-third of patients might have some perioperative complications, especially fever and urinary tract infections, which constitutes about 21%-39.8% of all the complications.
The primary aim of the study was to study about the proportion of patients getting post-operative infective complications following PCNL. The secondary aim was to study the patient, stone and procedure related risk factors associated with the infective complications.
This is an institution-based observational study.
All patients who underwent PCNL in the Department of Urology, Medical College, Thiruvananthapuram, during 3 years from September 2016- to August 2019, were included in the study. In this study, the demographic factors and factors related to the patient, stone, and the procedure were collected and analyzed.
Data analysis was performed using SPSS version 22.0.
During the 3-year period, a total of 201 patients with renal stones were treated with PCNL in our hospital. Of this 190 cases were taken for analysis. The mean age of patients was 47.7 years, 148 (77.9%) were male, 42 (22.1%) were female, The final outcomes evaluated were episodes of fever, documented urinary tract infection (UTI), pyelonephritis, and sepsis. Thirty-six (18.9%) patients had fever, of which 21 (11.1%) had UTI, 6 (3.1%) had pyelonephritis and 5 (2.6%) developed sepsis.
Post-PCNL complications are more commonly found in patients with history of preoperative UTI, previous history of renal surgeries, large stone burden, operative procedure more than 90 min, and presence of residual calculi.
经皮肾镜取石术（PCNL）被推荐为治疗直径大于2cm肾结石患者的首选治疗策略。据报道，高达三分之一的患者可能会出现一些围手术期并发症，尤其是发热和尿路感染，这约占所有并发症的21%-39.8%。
本研究的主要目的是研究PCNL术后感染性并发症患者的比例。次要目的是研究与感染性并发症相关的患者、结石和手术相关危险因素。
这是一项基于机构的观察性研究。
纳入2016年9月至2019年8月3年间在特里凡得琅医学院泌尿外科接受PCNL的所有患者。在本研究中，收集并分析了人口统计学因素以及与患者、结石和手术相关的因素。
使用SPSS 22.0版进行数据分析。
在这3年期间，我院共有201例肾结石患者接受了PCNL治疗。其中190例纳入分析。患者的平均年龄为47.7岁，男性148例（77.9%），女性42例（22.1%）。最终评估的结果包括发热、有记录的尿路感染（UTI）、肾盂肾炎和脓毒症发作。36例（18.9%）患者出现发热，其中21例（11.1%）发生UTI，6例（3.1%）发生肾盂肾炎，5例（2.6%）发生脓毒症。
PCNL术后并发症在有术前UTI病史、既往肾脏手术史、结石负荷大、手术时间超过90分钟以及存在残余结石的患者中更常见。
