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逆行可弯曲输尿管镜取石术后尿路感染和出血的危险因素分析

Analysis of risk factors for urinary tract infection and bleeding after retrograde flexible ureteroscopy for stone removal.

作者信息

Guo Tao, Zhang Jiaen, Gao Wenzhi, Ma Yixiang

机构信息

Department of Emergency, Peking University First Hospital, Beijing, China.

Department of Urology, Peking University First Hospital, Beijing, China.

出版信息

Front Surg. 2025 Apr 23;12:1573485. doi: 10.3389/fsurg.2025.1573485. eCollection 2025.

Abstract

OBJECTIVE

This study aimed to explore the risk factors for urinary tract infection (UTI) and bleeding after retrograde flexible ureteroscopy for stone removal, in order to prevent these complications and improve surgical outcomes.

METHODS

A retrospective analysis was conducted on 214 patients who underwent retrograde flexible ureteroscopy for kidney stones and ureteral stones from January 2015 to August 2022, with 135 patients having complete data. Clinical data, perioperative data, and stone characteristics were collected. Univariate and multivariate logistic regression analyses were performed to identify risk factors for UTI and bleeding after retrograde flexible ureteroscopy for stone removal.

RESULTS

The UTI rate after retrograde flexible ureteroscopy for stone removal was 8.15% (11/135), and the bleeding rate was 11.85% (16/135). Factors such as length of hospital stay ( = 0.034), stone size ( < 0.001), and preoperative creatinine ( = 0.016) were identified as risk factors for UTI after retrograde flexible ureteroscopy. Stone size ( = 0.004) was an independent risk factor for post-operative UTI. Stone size ( < 0.001), operation time ( < 0.001), and preoperative creatinine ( = 0.023) were risk factors for bleeding after retrograde flexible ureteroscopy. Stone size ( < 0.001) and operation time ( = 0.024) were independent risk factors for post-operative bleeding.

CONCLUSION

Stone size is an independent risk factor for UTI after retrograde flexible ureteroscopy for stone removal, while both stone size and operation time are independent risk factors for bleeding after the procedure.

摘要

目的

本研究旨在探讨逆行软性输尿管镜取石术后尿路感染(UTI)和出血的危险因素,以预防这些并发症并改善手术效果。

方法

对2015年1月至2022年8月期间接受逆行软性输尿管镜治疗肾结石和输尿管结石的214例患者进行回顾性分析,其中135例患者有完整数据。收集临床资料、围手术期资料和结石特征。进行单因素和多因素逻辑回归分析,以确定逆行软性输尿管镜取石术后UTI和出血的危险因素。

结果

逆行软性输尿管镜取石术后UTI发生率为8.15%(11/135),出血发生率为11.85%(16/135)。住院时间(=0.034)、结石大小(<0.001)和术前肌酐(=0.016)等因素被确定为逆行软性输尿管镜取石术后UTI的危险因素。结石大小(=0.004)是术后UTI的独立危险因素。结石大小(<0.001)、手术时间(<0.001)和术前肌酐(=0.023)是逆行软性输尿管镜取石术后出血的危险因素。结石大小(<0.001)和手术时间(=0.024)是术后出血的独立危险因素。

结论

结石大小是逆行软性输尿管镜取石术后UTI的独立危险因素,而结石大小和手术时间都是该手术后出血的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9996/12055797/9a8274fe260c/fsurg-12-1573485-g001.jpg

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