摘要
目的分析经皮肾镜取石术后发热的预测因素，为临床治疗提供参考。方法纳入2014年1月至2016年1月本院泌尿外科收治的行经皮肾镜取石术患者147例，根据术后是否存在发热将患者分为发热组与对照组，其中发热组共25例（发热率17．0％），对照组122例。收集患者术前信息，包括年龄、性别、术前肌酐水平、结石大小及形状、结石性质、受累。肾盏数、积水程度、尿培养结果等，术中信息包括手术时间、术中失血量、术中灌注量、肾盂积脓、穿刺通道长度、住院时间等，术后信息包括是否发热、术后是否有肾造瘘管并发症等。采用SPSS18．0进行统计学分析。结果两组患者结石表面积、结石CT值、结石形状、结石性质、受累肾盏数、肾积水程度、手术时间、术中失血量、术中灌注量、住院时间、肾造瘘管并发症发生率比较，差异均有统计学意义（均P〈0．05）。其余指标比较两组间差异均无统计学意义（均P〉0．05）。Logistic回归分析发现，结石表面积（OR=5．19）、结石性质（OR=7．86）、结石形状（OR=3．87）、手术时间（OR=5．68）、术中灌注量（OR=5．24）、肾造瘘管并发症（DR：2．65）为发热的影响因素。结论结石表面积较大、结石性质为感染性结石、结石形状为鹿角型结石、手术时间较长、术中灌注量较大、术后存在肾造瘘管并发症的患者更易出现术后发热。
Objective To analyze the predictive factors of fever after percutaneous renal stone sur- gery, and to provide reference for clinical treatment. Methods A total of 147 patients underwent percuta- neous nephrolithotomy in after operation was chosen in the Department of Urology in our hospital from Janu- ary 2014 to January 2016. According to the existence of fever, patients were divided into fever （n = 25, heating rate 17.0% ） and control （n -- 122 ） groups. Preoperative information were collected, including age, gender, preoperative serum creatinine, stone size and shape,the involvement of calyceal number,water, urine culture results, operative time, blood loss, intraoperative perfusion volume, pyonephrosis, puncture channel length ,hospitalization time and other information including intraoperative, postoperative information including fever, and postoperative renal fistula complications if there is information. SPSS 18.0 was used for statistical analysis. Results The fever group stone surface area, CT value affected calyx number, stone shape, stone properties,the involvement of ealyeeal number, degree of hydronephrosis, operative time, intra- operative blood loss, intraoperative perfusion, hospitalization time, and renal fistula complication rates were higher than the control group （ P 〈 0. 05 ）. There were no significant differences between two groups （ P 〉 0.05 ）. The results of Logistic regression analysis found that the stone surface area （ OR = 5.19 ） , stone, stone shape （ OR = 7.86 ） properties （ OR = 3.87 ）, operation time （ OR = 5.68 ） , intraoperative perfusion （ OR = 5.24）, and renal fistula complications （ OR = 2. 65 ） for the influence factors of fever. Conclusions The stone surface area is large, stone nature infection stones, stone shape for staghorn calculi, longer op- eration time, and intraoperative perfusion of large renal fistula complications were more prone to postopera- tive fever in postoperative.
出处
《中国医师杂志》
CAS
2017年第4期560-562,共3页
Journal of Chinese Physician
