Wang Guilin, Zheng Qihui, Ma Wentao, Yang Enguang, Jing Suoshi, Zhang Luyang, Jin Qi, He Qiqi, Li Xiaoran, Wang Zhiping
Department of Urology, Institute of Urology, Gansu Nephro-Urological Clinical Center, Key Laboratory of Urological Diseases in Gansu Province, Lanzhou University Second Hospital, Lanzhou, 730030, China.
Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou, 730030, China.
BMC Urol. 2025 Apr 12;25(1):88. doi: 10.1186/s12894-025-01778-8.
To evaluate the impact of intraoperative use of furosemide (FUR) in combination with dexamethasone (DEX) on postoperative complications following mini-percutaneous nephrolithotripsy (mini-PCNL).
The study was a retrospective cohort analysis of adult patients with kidney calculi treated with mini-PCNL. Exposure was the intravenous administration of FUR and DEX during mini-PCNL. The primary outcome was postoperative fever (≥ 38°C), whereas the secondary outcomes were other complications. Propensity score matching (PSM) was performed at a 1:1 ratio. Subgroup analyses and interaction tests were used to examine differences among different demographic groups.
The pre-matched and propensity score-matched cohorts included 237 and 166 patients, respectively. In the PSM cohort, postoperative fever (≥ 38°C) occurred in 8.4% (7/83) of the FUR + DEX group and 20.5% (17/83) of the control group. The combined use of FUR and DEX was associated with a lower postoperative fever (P = 0.027). There was no statistically significant difference between the FUR + DEX group and the control group for other complications, including SIRS, urosepsis, and pain-requiring opioids. SIRS occurred in 4.8% (4/83) of the FUR + DEX group versus 8.4% (7/83) in the control group, while urosepsis rates were 2.4% (2/83) versus 3.6% (3/83), respectively. Subgroup analysis showed a significant reduction in postoperative fever in patients with an operation time of ≥ 2 h in the FUR + DEX group, as indicated by the interaction test (P = 0.05).
The intravenous combined use of FUR and DEX in mini-PCNL reduces postoperative fever (≥ 38°C), particularly benefiting patients with an operative time of ≥ 2 h.
评估术中使用呋塞米（FUR）联合地塞米松（DEX）对微创经皮肾镜取石术（mini-PCNL）术后并发症的影响。
本研究是对接受mini-PCNL治疗的成年肾结石患者进行的一项回顾性队列分析。暴露因素为mini-PCNL术中静脉注射FUR和DEX。主要结局是术后发热（≥38°C），次要结局是其他并发症。采用1:1比例进行倾向评分匹配（PSM）。亚组分析和交互检验用于检验不同人口统计学组之间的差异。
匹配前和倾向评分匹配队列分别包括237例和166例患者。在PSM队列中，FUR + DEX组术后发热（≥38°C）发生率为8.4%（7/83），对照组为20.5%（17/83）。FUR和DEX联合使用与较低的术后发热相关（P = 0.027）。FUR + DEX组与对照组在其他并发症方面无统计学显著差异，包括全身炎症反应综合征（SIRS）、尿脓毒症和需要使用阿片类药物止痛的情况。FUR + DEX组SIRS发生率为4.8%（4/83），对照组为8.4%（7/83），而尿脓毒症发生率分别为2.4%（2/83）和3.6%（3/83）。亚组分析显示，交互检验表明FUR + DEX组中手术时间≥2小时的患者术后发热显著降低（P = 0.05）。
mini-PCNL术中静脉联合使用FUR和DEX可降低术后发热（≥38°C），尤其对手术时间≥2小时的患者有益。
