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逆行性肾内手术术后感染相关危险因素的前瞻性评估

Prospective Evaluation of Risk Factors Responsible for Infection Following Retrograde Intrarenal Surgery.

作者信息

Raj K Kishan, Adiga K Prashant, Chandni Clara D'souza Reshmina, B Nandakishore, Upadhyaya Rajani

机构信息

Urology, Father Muller Medical College and Hospital, Mangalore, IND.

General Surgery, Father Muller Medical College and Hospital, Mangalore, IND.

出版信息

Cureus. 2024 Apr 30;16(4):e59420. doi: 10.7759/cureus.59420. eCollection 2024 Apr.

Abstract

OBJECTIVE

The study aimed to identify the various risk factors for infective complications following retrograde intrarenal surgery (RIRS).

MATERIALS AND METHODS

The study was conducted over one year, and the incidence of infectious complications after RIRS was calculated. Patients were divided into two groups based on the presence and absence of infective complications and were compared in terms of preoperative and operative characteristics. The complications were assessed and graded according to the Modified Clavien classification system (MCCS). The Fisher's exact test, Student's t-test, and Mann-Whitney U test were used for univariate analysis. Multivariate logistic regression analysis was used to identify independent risk factors for postoperative urinary tract infection (UTI).

RESULTS

Out of 165 patients in the study, 27 (16.7%) patients developed UTI within one month of undergoing RIRS. The most frequent complication was fever, which occurred in 13 (7.8%) patients. When stratified by MCCS, 13 were grade I, nine were grade II, four were grade III, and one was a grade IV complication. High stone burden, concomitant diabetes mellitus, and multiple renal stones were identified as substantial risk factors for postoperative UTI in univariate analysis. On multivariate analysis, preoperative UTI and prolonged operative time were found to have a significant association with postoperative UTI.

CONCLUSION

The present study demonstrated that preoperative UTI and prolonged operative time are independent factors responsible for postoperative UTI. Large stone burden, stone multiplicity, and diabetes mellitus contribute to a higher risk for UTI following RIRS.

摘要

目的

本研究旨在确定逆行性肾内手术(RIRS)后感染性并发症的各种危险因素。

材料与方法

本研究为期一年,计算RIRS后感染性并发症的发生率。根据是否存在感染性并发症将患者分为两组,并比较术前和手术特征。根据改良Clavien分类系统(MCCS)对并发症进行评估和分级。采用Fisher精确检验、Student t检验和Mann-Whitney U检验进行单因素分析。采用多因素logistic回归分析确定术后尿路感染(UTI)的独立危险因素。

结果

本研究的165例患者中,27例(16.7%)在接受RIRS后1个月内发生UTI。最常见的并发症是发热,13例(7.8%)患者出现发热。根据MCCS分层,13例为I级,9例为II级,4例为III级,1例为IV级并发症。在单因素分析中,结石负荷高、合并糖尿病和多发性肾结石被确定为术后UTI的重要危险因素。多因素分析发现,术前UTI和手术时间延长与术后UTI显著相关。

结论

本研究表明,术前UTI和手术时间延长是术后UTI的独立影响因素。结石负荷大、结石多发和糖尿病会增加RIRS后UTI的风险。

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