经皮肾镜碎石取石术后SIRS发生的影响因素分析

王爱会; 李文杰; 牛洪流; 赵建军

doi:10.13898/j.cnki.issn.1000-2200.2021.12.020

经皮肾镜碎石取石术后SIRS发生的影响因素分析

Analysis of influencing factors of SIRS after percutaneous nephrolithotomy based on log-binomial regression model

摘要

摘要:
目的基于log-binomial回归模型分析经皮肾镜碎石取石术后炎症反应综合征（systemic inflammatory response syndrome，SIRS）发生的影响因素。
方法选取行经皮肾镜碎石取石术的病人80例，根据术后是否发生SIRS分为SIRS组（n=23）和对照组（n=57）。将年龄、性别、同侧结石手术史、术前是否留置双J管、术前尿培养情况、手术时间、取石通道、术后是否输血、结石直径、术后结石残留情况、结石形状设为自变量，将是否发生术后SIRS设为因变量，拟合log-binomial回归模型。
结果单因素log-binomial回归分析结果显示，术前尿培养情况、手术时间、多通道取石、术后输血、结石直径、鹿角形结石均为影响病人经皮肾镜碎石取石术后发生SIRS的影响因素（P < 0.01）。术前尿培养阳性、手术时间>60 min、多通道取石、术后输血、结石直径≥ 50 mm、鹿角形结石的病人，术后发生SIRS的风险较高（P < 0.01），现患比值分别为2.14、2.33、2.85、2.65、2.59。
结论经皮肾镜碎石取石术后SIRS的发生为多种因素综合作用的结果，临床上对于术前尿培养阳性、手术时间>60 min、多通道取石、结石直径≥ 50 mm、鹿角形结石的病人应提高警惕。

Abstract:
ObjectiveTo analyze the influencing factors of systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy based on log-binomial regression model.
MethodsEighty patients who underwent percutaneous nephrolithotomy were divided into SIRS group(n=23) and control group(n=57).The age, gender, ipsilateral stone operation history, preoperative indwelling double-J tube or not, preoperative urine culture, operation time, lithotomy channel, postoperative blood transfusion or not, stone diameter, postoperative residual stone and stone shape were set as independent variables, and postoperative SIRS or not was set as dependent variable to fit the log-binomial regression model.
ResultsUnivariate log-binomial regression analysis showed that preoperative urine culture, operation time, multi-channel lithotomy, postoperative blood transfusion, stone diameter and staghorn stone were the influencing factors of SIRS after percutaneous nephrolithotomy(P < 0.01).The patients with positive urine culture before operation, operation time >60 min, multi-channel lithotomy, postoperative blood transfusion, stone diameter ≥ 50 mm and staghorn stone had higher risk of SIRS(P < 0.01), and the prevalence ratio was 2.14, 2.33, 2.85, 2.65 and 2.59, respectively.
ConclusionsThe occurrence of SIRS after percutaneous nephrolithotomy is due to multiple factors.It should be paid more attention to the patients with positive urine culture before operation, operation time >60 min, multi-channel lithotomy, stone diameter ≥ 50 mm and staghorn stone in clinic.

HTML全文

参考文献(20)

施引文献

资源附件(0)