Zhou Hongmin, Xie Tiancheng, Gao Yuchen, Yao Xudong, Xu Yunfei
Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
J Pers Med. 2023 Jan 20;13(2):187. doi: 10.3390/jpm13020187.
To predict the occurrence of systemic inflammatory response syndrome (SIRS) after percutaneous nephrostrolithotomy(PCNL), preoperative urine culture is a popular method, but the debate about its predictive value is ongoing. In order to better evaluate the value of urine culture before percutaneous nephrolithotomy, we conducted a single-center retrospective study.
A total of 273 patients who received PCNL in Shanghai Tenth People's Hospital from January 2018 to December 2020 were retrospectively evaluated. Urine culture results, bacterial profiles, and other clinical information were collected. The primary outcome observed was the occurrence of SIRS after PCNL. Univariate and multivariate logistic regression analysis was performed to determine the predictive factors of SIRS after PCNL. A nomogram was constructed using the predictive factors, and the receiver operating characteristic (ROC) curves and calibration plot were drawn.
Our results showed that there was a significant correlation between positive preoperative urine cultures and the occurrence of postoperative systemic inflammatory response syndrome. Meanwhile, diabetes, staghorn calculi, and operation time were also risk factors for postoperative systemic inflammatory response syndrome. Our results suggest that among the positive bacteria in urine culture before percutaneous nephrolithotomy, has become the dominant strain.
Urine culture is still an important method of preoperative evaluation. A comprehensive evaluation of multiple risk factors should be undertaken and heeded to before percutaneous nephrostrolithotomy. In addition, the impact of changes in bacterial drug resistance is also worthy of attention.
为预测经皮肾镜取石术(PCNL)后全身炎症反应综合征(SIRS)的发生,术前尿培养是一种常用方法,但关于其预测价值的争论仍在继续。为了更好地评估经皮肾镜取石术前尿培养的价值,我们进行了一项单中心回顾性研究。
回顾性评估2018年1月至2020年12月在上海第十人民医院接受PCNL的273例患者。收集尿培养结果、细菌谱及其他临床信息。观察的主要结局是PCNL后SIRS的发生。进行单因素和多因素逻辑回归分析以确定PCNL后SIRS的预测因素。使用预测因素构建列线图,并绘制受试者工作特征(ROC)曲线和校准图。
我们研究结果表明,术前尿培养阳性与术后全身炎症反应综合征的发生之间存在显著相关性。同时,糖尿病、鹿角形结石和手术时间也是术后全身炎症反应综合征的危险因素。我们的研究结果表明,在经皮肾镜取石术前尿培养中的阳性细菌中, 已成为优势菌株。
尿培养仍然是术前评估的重要方法。在经皮肾镜取石术前应进行并重视对多种危险因素的综合评估。此外,细菌耐药性变化的影响也值得关注。