摘要
摘要目的分析在输尿管结石伴复杂性尿路感染(UTI)患者输尿管镜操作后引起全身炎症反应综合征(SIRS)及感染性休克的危险因素,寻求更加有效和安全的输尿管镜手术方式.方法回顾性分析１８２例进行了输尿管镜操作的输尿管结石伴UTI的病例,分别就肾盂尿培养细菌种类、手术方式、手术时间对SIRS及感染性休克发生的关系进行比较分析.结果大肠埃希氏菌为主要致病菌(５７％),但G＋菌术后发生感染性休克的几率更高;存在输尿管积脓的情况下一旦手术时间大于１０分钟,术后发生SIRS和感染性休克的几率明显增大;在碎石操作的手术中,术中置入输尿管插管引流能显著降低SIRS及感染性休克的发生率.结论术中一旦发现输尿管积脓应尽快结束手术.需行碎石操作的手术,术中应尽可能的置入输尿管插管引流,但手术时间不宜超过５０分钟.关键词输尿管结石;复杂性的泌尿道感染;输尿管镜;全身炎症反应综合征;感染性休克Thereportandprognosisabout１８２patientswhosufferfromureteralcalculuswithUTIandunderwentureteroscopicoperationAbstractObjectiveToexploreamoreeffectiveandsafertherapeuticstrategy,weanalyzedtheriskfactorscausingpostoperativesystemicinflammatoryresponsesyndrome(SIRS)andinfectiveshockinureteralcalculuswithUTIwhounderwentureteroscopicoperaton．MethodsAretrospectiveclinicalstudywasperformedon１８２patientswhosufferfromureteralcalculuswithUTIandunderwentureteroscopicoperation．Riskfactorssuchaspathogenicbacteria、operationway、operationtime,wereanalyzedtoassessstatisticalassociationwiththeoccurrenceofpostoperativeSIRSand．nfectiveshock．ResultsAlthoughEscherichiacoliwasthechiefpathogenicbacteria(５７％),butgram－positivebacteriummorelikelytocauseinfectiveshock．UreterempyematawillriseincidenceofSIRSandinfectiveshock,whentimeofoperatonmorethan１０min．DrainoffwaterbycannulawillreduceriseincidenceofSIRSandinfectiveshockwhentimeofoperatonlessthan５０min．ConclnsionTerminationofoＧperationisnecessaryonceureterempyemataismeasured．Whenholmiumlaserlithotripsyisnecessary,drainageisaeffectivewaytoReduceincidenceofSIRSandinfecＧtiveshock．．Keywordsreteralcalculus,UTI,ureteroscopicoperation,SIRSandinfectiveshock．中图分类号R６９文献标识码B文章编号１００８－６３１５(２０１５)１２－０７８２－０２
出版日期
2015年12月22日（中国期刊网平台首次上网日期，不代表论文的发表时间）
