PCNL 术后尿毒症的预测:一项回顾性队列研究

Zulker Naimul Islam, Monirul Islam, Probir Kumar Roy, Nitai Pada Biswas
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摘要

导言:经皮肾镜取石术(PCNL)被认为是一种从肾脏或输尿管上部取出结石的微创方法。PCNL 可引起多种并发症,如尿崩症,这是一种罕见但严重的并发症。方法:孟加拉国达卡 Shere-e-Banglanagar 国家肾脏疾病和泌尿外科研究所泌尿外科对 2022 年 6 月至 2023 年 7 月期间接受 PCNL 的患者进行了一项回顾性队列研究。数据通过使用 Best CARE 系统进行病历审查收集。使用 SPSS 23 版本(IBM Corporation,Armonk,NY,USA)。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。K-S 检验用于检查数据的正态性。使用独立样本 t 检验和非参数 Mann-Whitney 检验比较组间定量变量。费雪精确检验用于比较分类变量。结果本研究共纳入 100 名患者。参与者的平均年龄为 49 岁。约 70 人(70%)为男性。关于尿毒症的风险因素,35 名参与者(38%)患有糖尿病。PCNL 术后尿毒症的发生率为 3 例(1.9%)。最常报告的适应症是单侧肾结石。在分析中发现,最常报告的结石类型是草酸钙,占患者总数的近三分之二,达 63% (63%)。结论在接受 PCNL 的患者中,尿毒症的发生率低于 2%。参与者中最常见的并发症是糖尿病,其次是高血压。美罗培南是治疗尿毒症患者的首选抗生素。
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Prediction of Urosepsis Following PCNL: A Retrospective Cohort Study
Introduction: The procedure of percutaneous nephrolithotomy (PCNL) is considered a minimally invasive method for removing stones from the kidneys or upper 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 June 2022 to July 2023 was conducted at Department of Urology, National Institute of Kidney diseases and Urology, Shere-e-Banglanagar, Dhaka, Bangladesh. Data were collected by chart review using the Best CARE 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 100 patients were included in this study. The mean age of the participants overall was found to be 49. About 70 (70%) of the participants were male. Regarding risk factors for urosepsis, diabetes mellitus was found in 35 (38%) 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 63 (63%) 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. Inj Meropenam was the antibiotic of choice when treating patients and following urosepsis.
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