CAJ | 학술논문

目的探讨术后系统性炎症反应综合征(SIRS)与经皮肾镜碎石术(PCNL)术前中段尿及术中肾盂尿的相关性.方法共纳入450例行PCNL的尿路结石患者,均于PCNL术前留取中段尿,并于术中留取肾盂尿.结果 450例患者中,术前中段尿细菌培养阳性100例(22.2％,100/450),术中肾盂尿细菌培养阳性85例(18.9％,85/450)；46例(10.2％,46/450)术后发生SIRS.术中肾盂尿细菌培养阳性患者中20例(23.5％,20/85)术前中段尿细菌培养阳性,术中肾盂尿细菌培养阴性患者中80例(21.9％,80/365)术前中段尿细菌培养阳性,两者比较差异无统计学意义(P＞0.05).术前中段尿细菌培养阳性患者中15例(15.0％,15/100)出现SIRS,术前中段尿细菌培养阴性患者中31例(8.9％,31/350)出现SIRS,两者比较差异无统计学意义(P＞0.05).术中肾盂尿细菌培养阳性患者中18例(21.2％,18/85)出现SIRS,术中肾盂尿细菌培养阴性患者中28例(7.7％,28/365)出现SIRS,两者比较差异有统计学意义(P＜0.05).结论术前中段尿与术后SIRS的发生无显著相关性,术中肾盂尿细菌培养阳性可以预测术后SIRS的发生,给予相应的抗生素治疗可以提高PCNL的安全性.
목적 탐토술후계통성염증반응종합정(SIRS)여경피신경쇄석술(PCNL)술전중단뇨급술중신우뇨적상관성.방법 공납입450례행PCNL적뇨로결석환자,균우PCNL술전류취중단뇨,병우술중류취신우뇨.결과 450례환자중,술전중단뇨세균배양양성100례(22.2％,100/450),술중신우뇨세균배양양성85례(18.9％,85/450)；46례(10.2％,46/450)술후발생SIRS.술중신우뇨세균배양양성환자중20례(23.5％,20/85)술전중단뇨세균배양양성,술중신우뇨세균배양음성환자중80례(21.9％,80/365)술전중단뇨세균배양양성,량자비교차이무통계학의의(P＞0.05).술전중단뇨세균배양양성환자중15례(15.0％,15/100)출현SIRS,술전중단뇨세균배양음성환자중31례(8.9％,31/350)출현SIRS,량자비교차이무통계학의의(P＞0.05).술중신우뇨세균배양양성환자중18례(21.2％,18/85)출현SIRS,술중신우뇨세균배양음성환자중28례(7.7％,28/365)출현SIRS,량자비교차이유통계학의의(P＜0.05).결론 술전중단뇨여술후SIRS적발생무현저상관성,술중신우뇨세균배양양성가이예측술후SIRS적발생,급여상응적항생소치료가이제고PCNL적안전성.
Objective To explore the relationship of postoperative systemic inflammatory response syndrome (SIRS) and preoperative midway through the urine and perioperative renal pelvis urine of percutaneous nephrostolithotomy (PCNL).Methods Participants included 450 patients with urinary calculus who underwent PCNL,preoperative midway through the urine and perioperative renal pelvis urine of PCNL was collected.Results Of 450 cases,preoperative midway through the urine germiculture positive 100 cases (22.2％,100/450 ),perioperative renal pelvis urine germiculture positive 85 cases (18.9％,85/450),46 cases ( 10.2％,46/450) occurred SIRS after PCNL.Decompression of perioperative renal pelvis urine germiculture positive 20 cases (23.5％,20/85) preoperative midway through the urine germiculture positive,perioperative renal pelvis urine the bacteria cultures negative 80 cases (21.9％,80/365 ) preoperative midway through the urine germiculture positive (P ＞0.05),preoperative midway through the urine germiculture positive 15 cases ( 15.0％,15/100) in SIRS,preoperative midway through the urine the bacteria cultures negative 31 cases ( 8.9％,31 /350) in SIRS (P ＞ 0.05 ).Decompression of perioperative renal pelvis urine germiculture positive 18 cases (21.2％,18/85) in SIRS,perioperative renal pelvis urine the bacteria cultures negative 28 cases (7.7％,28/365) in SIRS (P ＜ 0.05 ).Conclusion Preoperative midway through the urine has no correlation with the occurrence of SIRS,perioperative renal pelvis urine germiculture positive can predict the occurrence of SIRS,giving corresponding antibiotic treatment can improve the security of PCNL.