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利雅得阿卜杜勒阿齐兹国王医疗城经皮肾镜取石术后尿脓毒症的预测因素

Predictors of Urosepsis Post Percutaneous Nephrolithotomy at King Abdulaziz Medical City, Riyadh.

作者信息

Alhamad Fahad S, Alathel Abdulaziz, Aljaafri Ziad A, Alhadlaq Khalid H, Alghamdi Abdullah, AlHoshan Yazeed S, Alfraidi Omar

机构信息

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.

Urology, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.

出版信息

Cureus. 2023 May 26;15(5):e39542. doi: 10.7759/cureus.39542. eCollection 2023 May.

Abstract

INTRODUCTION

The procedure of percutaneous nephrolithotomy (PCNL) is considered a minimally invasive method for removing stones from the kidneys or ureters. PCNL can cause a wide range of complications, such as urosepsis, a rare but serious complication.

METHODS

A retrospective cohort study of patients who underwent PCNL from the period 2016 to 2022 was conducted at King Abdulaziz Medical City. Data were collected by chart review using the BestCARE system. SPSS version 23 (IBM Corporation, Armonk, NY, USA) was used. Qualitative variables were expressed as percentages and frequencies. The chi-square test was used to compare the qualitative variables. The K-S test was used to check the normality of the data. Quantitative variables were compared between groups using the independent sample t-test and the nonparametric Mann-Whitney test. Fisher's exact test was used to compare categorical variables.

RESULTS

A total of 155 patients were included in this study. The mean age of the participants overall was found to be 49. About 108 (69.7%) of the participants were male. Regarding risk factors for urosepsis, diabetes mellitus was found in 54 (34.8%) of the participants. The incidence of urosepsis following PCNL was found to be 3 (1.9%) of the patients. The most frequently reported indication was found to be unilateral renal stones. The most frequently reported type of stone in the analysis was found to be calcium oxalate in nearly two-thirds 98 (63.2%) of the patients.

CONCLUSION

The incidence of urosepsis among the patients who underwent PCNL was less than 2%. Diabetes mellitus, followed by hypertension, were the most prevalent co-morbidities among the participants. Cefuroxime was the antibiotic of choice when treating patients and following urosepsis.

摘要

引言

经皮肾镜取石术(PCNL)是一种用于清除肾脏或输尿管结石的微创方法。PCNL可引发多种并发症,如尿脓毒症,这是一种罕见但严重的并发症。

方法

在阿卜杜勒阿齐兹国王医疗城对2016年至2022年期间接受PCNL的患者进行了一项回顾性队列研究。通过使用BestCARE系统查阅病历收集数据。使用SPSS 23版(美国纽约州阿蒙克市IBM公司)。定性变量以百分比和频率表示。采用卡方检验比较定性变量。使用K-S检验检查数据的正态性。采用独立样本t检验和非参数曼-惠特尼检验比较组间定量变量。采用费舍尔精确检验比较分类变量。

结果

本研究共纳入155例患者。参与者的总体平均年龄为49岁。约108名(69.7%)参与者为男性。关于尿脓毒症的危险因素,54名(34.8%)参与者患有糖尿病。PCNL术后尿脓毒症的发生率为3例(1.9%)患者。最常报告的指征是单侧肾结石。分析中最常报告的结石类型是草酸钙,近三分之二的患者即98例(63.2%)为此类型。

结论

接受PCNL的患者中尿脓毒症的发生率低于2%。糖尿病,其次是高血压,是参与者中最常见的合并症。头孢呋辛是治疗患者及尿脓毒症后的首选抗生素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc60/10290906/f54f9b50daad/cureus-0015-00000039542-i01.jpg

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