Hori Shunsuke, Yamasaki Tomoya, Fujio Kei, Otsuki Hideo, Nakajima Koichi, Mitsui Yozo
The Department of Urology Toho University Faculty of Medicine; Abiko Toho Hospital.
Abiko Toho Hospital.
Hinyokika Kiyo. 2023 Apr;69(4):101-106. doi: 10.14989/ActaUrolJap_69_4_101.
Febrile urinary tract infection (f-UTI) is a common complication after ureterorenoscopic lithotripsy (URSL) but is sometimes lethal. In this article, we analyzed the factors of post URSL f-UTI. We retrospectively evaluated the association between the development of f-UTI and patients, stones, and perioperative factors in 695 cases in which URSL was performed at our institution from September 2015 to 2018. Seventy-six of the 695 patients (10.9%) had postoperative f-UTI. Elderly (p＝0.013), female (p＝0.02), and hypertension (p＝0.001) patients had significantly higher rates of f-UTI. Renal stone (p＝0.001) cases showed significantly higher rates of f-UTI. Preoperative urine positive culture (p＝0.045), preoperative f-UTI (p＜0.001), URSL procedure using flexible ureteroscopy (p＝0.048), non-stone-free (p＝0.006), long operation time (p＝0.011), preoperative urinary stent insertion due to preoperative f-UTI (p＜0.001), were factors associated with post-operative f-UTI. Multivariate analysis revealed that hypertension (OR＝2.08, p＝0.008) and preoperative f-UTI (OR＝3.739, p＝0.033) were independent factors of postoperative f-UTI. Patients with hypertension or preoperative f-UTI should be managed more carefully during the perioperative period, suspecting that they are more likely to develop postoperative f-UTI.
发热性尿路感染（f-UTI）是输尿管镜碎石术（URSL）后常见的并发症，但有时会危及生命。在本文中，我们分析了输尿管镜碎石术后f-UTI的相关因素。我们回顾性评估了2015年9月至2018年在我院接受输尿管镜碎石术的695例患者中f-UTI的发生与患者、结石及围手术期因素之间的关联。695例患者中有76例（10.9%）术后发生f-UTI。老年患者（p＝0.013）、女性患者（p＝0.02）和高血压患者（p＝0.001）发生f-UTI的比率显著更高。肾结石患者（p＝0.001）发生f-UTI的比率显著更高。术前尿培养阳性（p＝0.045）、术前f-UTI（p＜0.001）、使用软性输尿管镜的输尿管镜碎石术（p＝0.048）、结石残留（p＝0.006）、手术时间长（p＝0.011）、因术前f-UTI而在术前插入输尿管支架（p＜0.001）均为术后f-UTI的相关因素。多因素分析显示，高血压（OR＝2.08，p＝0.008）和术前f-UTI（OR＝3.739，p＝0.033）是术后f-UTI的独立因素。对于高血压或术前f-UTI患者，围手术期应更谨慎地管理，因为怀疑他们更易发生术后f-UTI。
