CAJ | 학술논문

目的：分析经皮肾镜穿刺取石术（ PCNL）后发热的相关因素，探讨术后发热的原因及其护理对策。方法回顾性分析2013年4－8月104例上尿路结石行PCNL术患者的临床资料，调查患者术前血尿常规结果、中段尿细菌培养结果（是否合并尿路感染）、结石大小、碎石时间、术后留置肾造瘘管时间、是否发热（体温≥38．5℃）等，分析发热的相关因素。结果共30例患者PCNL术后发热（28．8％），其余74例未发热（71．2％）。术前合并尿路感染、结石大（直径＞20 mm）、碎石时间长（＞40 min）、术后留置管道时间长（≥2周）是PCNL术后发热的相关因素，对发热的影响有统计学意义（ P＜0．01或P＜0.05）。结论发热是PCNL术后常见的并发症，严格控制碎石时间、尽量缩短术后留置管道时间、采取相应的护理措施是防止PCNL后发热的有效方法。
목적：분석경피신경천자취석술（ PCNL）후발열적상관인소，탐토술후발열적원인급기호리대책。방법회고성분석2013년4－8월104례상뇨로결석행PCNL술환자적림상자료，조사환자술전혈뇨상규결과、중단뇨세균배양결과（시부합병뇨로감염）、결석대소、쇄석시간、술후류치신조루관시간、시부발열（체온≥38．5℃）등，분석발열적상관인소。결과공30례환자PCNL술후발열（28．8％），기여74례미발열（71．2％）。술전합병뇨로감염、결석대（직경＞20 mm）、쇄석시간장（＞40 min）、술후류치관도시간장（≥2주）시PCNL술후발열적상관인소，대발열적영향유통계학의의（ P＜0．01혹P＜0.05）。결론발열시PCNL술후상견적병발증，엄격공제쇄석시간、진량축단술후류치관도시간、채취상응적호리조시시방지PCNL후발열적유효방법。
Objective To analyze factors associated with postoperative fever induced by percutaneous nephrostolithotomy ( PCNL) and nursing strategy .Methods Our study made a retrospective analysis of the medical data of 104 cases of calculus of upper urinary tract, that had PCNL in the hospital from April to August 2013.Before surgery, the blood and urine routine detection results , the bacterial culture results of midstream urine , the sizes of the stone , the duration of lithotrity , the duration of indwelling catheter , fe-ver (≥38.5℃), etc.were studied and related factors associated with fever were analyzed accordingly .Results Following PCNL, 30 patients developed fever , accounting for 28.8%, and remaining 74 patients had no fever, accounting for 71.2%(P=0.00).Compli-cation with urinary infection before surgery , large sizes of stone ( diameter of the stone >20 mm) , long duration of lithotrity , and long duration of indwelling catheter (≥2 weeks) were all factors related with fever after surgery .Statistical significance could be noted in the effect of fever (P<0.01 or P<0.05).Conclusion Fever is a common complication following percutaneous lithotripsy .Strict control of lithotrity duration , duration of indwelling catheter as short as possible and proper nursing measures were all effective methods for the prevention of fever after PCNL .