硬输尿管镜治疗上尿路结石后尿路感染的危险因素分析

Shengyin Hu
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摘要

目的分析硬输尿管镜治疗上尿路结石术后尿路感染的危险因素。方法选取2017年4月至2018年7月在大同市第五人民医院硬输尿管镜下治疗上尿路结石后尿路感染的患者37例。37例患者经硬输尿管镜治疗后,用无菌管收集清洗后的尿液标本,立即送实验室细菌室进行细菌培养。详细记录患者的年龄、性别、体重指数、结石主要直径、结石梗阻类型、手术时间及相关基础疾病如糖尿病、高血压等。分析上述因素与术后尿路感染的关系。结果37例硬输尿管镜治疗上尿路结石后尿路感染患者共培养病原菌64株。其中以革兰氏阴性菌居多,以肺炎克雷伯菌和大肠杆菌为主,分别占18.75%(12/64)和35.94%(23/64)。革兰氏阳性菌中以金黄色葡萄球菌和粪肠球菌为主,分别占7.81%(5/64)和6.25%(4/64)。真菌仅有2株,占3.13%。上尿路结石硬输尿管镜术后尿路感染的危险因素为年龄、结石主要直径、结石梗阻类型、糖尿病及手术时间(P<0.05)。结论年龄、结石主要直径、结石梗阻类型、糖尿病及手术时间是硬输尿管镜下治疗上尿路结石患者尿路感染的危险因素。主要致病菌为革兰氏阴性菌。关键词:输尿管镜;上尿路结石;感染;高危因素
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Risk factors of urinary tract infection after rigid ureteroscopy for upper urinary tract calculi
Objective To analyze the risk factors of urinary tract infection after rigid ureteroscopy for upper urinary tract calculi. Methods A total of 37 patients with urinary tract infection after rigid ureteroscopy for upper urinary tract calculi who were treated in the Fifth People’s Hospital of Datong from April 2017 to July 2018 were enrolled. After rigid ureteroscopy treatment, cleaned urine samples were collected from the 37 patients by sterile tubes, and were immediately sent to the laboratory bacteria room for bacterial culture. The patient’s age, gender, body mass index, major diameter of stone, type of stone obstruction, operation time, and related basic diseases such as diabetes mellitus and hypertension were recorded in detail. The relationships between the above factors and postoperative urinary tract infection were analyzed. Results A total of 64 pathogenic bacteria were cultured in 37 patients with urinary tract infection after rigid ureteroscopy for upper urinary tract calculi. Most of them were Gram-negative bacteria, of which the Klebsiella pneumoniae and Escherichia coli were dominant, accounting for 18.75% (12/64) and 35.94% (23/64) respectively. Among Gram-positive bacteria, Staphylococcus aureus and Enterococcus faecalis were the predominant types, accounting for 7.81% (5/64) and 6.25%(4/64), respectively. There were only 2 strains of fungi, accounting for 3.13%. The risk factors of urinary tract infection after rigid ureteroscopy for upper urinary tract calculi were age, major diameter of stone, type of stone obstruction, diabetes mellitus and operation time (P<0.05). Conclusions Age, major diameter of stone, type of stone obstruction, diabetes mellitus and operative time are risk factors of urinary tract infection in patients with upper urinary tract calculi treated by rigid ureteroscopy. And the major pathogenic bacteria of the disease are Gram-negative bacteria. Key words: Ureteroscopy; Upper urinary tract calculi; Infection; High risk factors
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