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2018智能控压输尿管软镜碎石术后发生全身炎症反应综合征的临床分析

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发表于 2018-8-18 11:37:22 | 显示全部楼层 |阅读模式
  [摘要] 目的 探讨智能控压输尿管软镜碎石术治疗肾结石术后发生全身炎症反应综合征(SIRS)的有效预防措施。方法 方便选取并回顾性分析该院2016年1月―2017年2月采用智能控压输尿管软镜碎石术治疗肾结石患者188例的临床资料。结果 188例肾结石患者均成功手术,术后确诊SIRS 者11例,占5.85%。女性组(10.12%)与男性组(2.91%),尿培养为GNB组(20.00%)与非GNB组(3.68%),感染性结石组(13.04%)与非感染性结石组(1.13%)术后SIRS的发生率差异有统计学意义(P http://
  [关键词] 智能控压输尿管软镜;肾结石;全身炎性反应综合征
  [中图分类号] R699 [文献标识码] A [文章编号] 1674-0742(2017)11(c)-0088-03
  [Abstract] Objective This paper tries to explore the preventive measures of SIRS after treatment of renal calculi with intelligent pressure-controlled ureter soft lithotripsy. Methods 188 cases of renal calculi treated by intelligent controlled ureteroscopic soft lithotripsy from January 2016 to February 2017 were convenient selection and analyzed. Results 188 patients were performed the surgery successfully, and 11 patients(5.85%) developed SIRS. There were significant differences between two groups in gender, female accounting for 10.12%, male accounting for 2.91%, mid-stream urine culture were Gram-negative bacteria (20.00%) and Non-gram negative bacteria (3.68%), the infectious stone in the gorup of(13.04%) and non-infectious stone of (1.13%) in the development of SIRS, with significant difference(P38℃或90次/分;③呼吸>20次/分或PaCO212×109/L,或    采用SPSS 19.0 统计学软件进行处理,计数资料用百分率(%)表示,行χ2检验,P12×109/L,其中1例(0.53%)出现感染性休克,经积极治疗后好转,无死亡病例。在SIRS发生因素方面,女性组(10.12%)与男性组(2.91%),尿培养为GNB组(20.00%)与非GNB组(3.68%),感染性结石组(13.04%)与非感染性结石组(1.13%)术后SIRS的发生率差异有统计学意义(P参考文献]
  [1] 董圣芳,杨建勋.上尿路结石患者经皮肾镜术后全身炎性反应综合征发生情况及危险因素分析[J].解放军预防医学杂志,2017,35(2):149-152.
  [2] 邓小林,宋乐明,钟久庆,等.可智能监控肾盂内压的输尿管软镜吸引取石术的临床应用[J].中华泌尿外科志,2016,37(5):385-388.
  [3] 刘星明,吴元昱,沈乾,等.输尿管软镜钬激光碎石术治疗上尿路结石并发症的防治措施[J].现代实用医学,2017,29(1):64-66.
  [4] 龚宾宾,梁朝朝,郝宗耀,等.经皮肾镜取石术治疗肾脏感染性结石的疗效分析(附127例报告)[J].临床泌尿外科杂志,2014,29(7):567-569.
  [5] 张艳涛,刘晓龙,刘桂彬,等.经皮肾镜取石术围手术期全身炎症反应综合征的影响因素[J].天津医科大学学报,2015, 21(4):321-323.
  [6] 熊海云,曾小明,余明主,等.经皮肾镜取石术前尿培养与术后全身炎症反应综合征的关系[J].临床泌尿外科杂志,2014, 29(2):106-107.
  [7] 张剑波.泌尿系统结石经皮肾镜手术后发生尿源性脓毒血症的影响因素[J].国际泌尿系统杂志,2016,36(2):187-190.
  [8] 赖德辉,李逊,何永忠,等.?皮肾镜取石术和输尿管软镜碎石术治疗肾结石(>2cm)并发症的Meta分析[J].现代泌尿外科杂志,2016,21(4):283-288.
  (收稿日期:2017-08-26)
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