影响老年上尿路结石患者术后感染的多因素分析

Analysis of multiple factors affecting postoperative infection in elderly patients with upper urinary tract stones

中文关键词: 老年  上尿路结石  手术  术后感染  影响因素  预后

英文关键词: elderly  upper urinary tract stone  surgery  postoperative infection  influencing factor  prognosis

中文摘要:

      目的 分析老年上尿路结石患者术后感染现状及影响因素,为临床患者的预后改善提供更多借鉴.方法 回顾性选取2020年12月 2023年5月于六安市中医院接受手术治疗的老年上尿路结石患者,记录患者的人口学资料、既往病史和合并症、手术指标、结石情况、术前实验室指标和住院相关指标值,分析影响患者术后尿路感染的相关因素.结果 本研究180例患者中,有40例术后出现尿路感染,感染率为22.22％(40/180).感染组和未感染组患者年龄、结石梗阻类型、结石发病状况、手术方式、性别、上尿路结石史、置管后残留结石、高血压病史、抗生素使用种类差异均无统计学意义(P＞0.05).感染组和未感染组患者结石直径、糖尿病史、导尿管留置时间、术前尿白细胞水平、术前血CRP水平、术前白蛋白、前白蛋白、血红蛋白水平、手术时间、尿亚硝酸盐活性阳性、尿培养阳性差异均有统计学意义(P＜0.05).多因素Logistic回归分析显示,糖尿病史、手术时间、结石直径、术前尿白细胞水平、术前白蛋白水平和尿培养阳性为影响患者术后尿路感染的独立危险因素(P＜0.05).结论 结石直径、糖尿病史、手术时间、术前尿白细胞水平、术前白蛋白水平和尿培养阳性等可能为导致患者术后感染的相关因素,临床针对上述危险因素应尽早干预,以改善患者预后状况.

英文摘要:

      Objective To analyze the status quo and influencing factors of postoperative infection in elderly patients with upper urinary tract stones,and provide more reference for improving the prognosis of patients.Methods Elderly patients with upper urinary tract stones who received surgical treatment in Traditional Chinese Medicine Hospital of Lu'an City from De-cember 2020 to May 2023 were retrospectively selected.Their demographic data,past medical history,comorbidities,surgical indicators,calculus situation,preoperative laboratory indicators and hospitalization-related indicators were recorded.The related factors affecting postoperative urinary tract infection were analyzed.Results Among the 180 patients in this study,40 ones de-veloped urinary tract infections after surgery,with an infection rate of 22.22％(40/180).There was no significant difference in age,type of stone obstruction,stone occurrence,surgical method,gender,history of upper urinary tract stones,residual stones after catheterization,history of hypertension,and antibiotic use between the infected and the uninfected groups(P＞0.05).There were significant differences in stone diameter,diabetes history,catheter retention time,preoperative levels of u-rinary white blood cell,blood CRP,albumin,prealbumin and hemoglobin,operative time,positive urinary nitrite activity and positive urine culture between the two groups(P＜0.05).Multivariate Logistic regression analysis showed that diabetes histo-ry,operation time,stone diameter,preoperative urinary white blood cell level,preoperative albumin level and positive urine culture were independent risk factors for postoperative urinary tract infection(P＜0.05).Conclusion Stone diameter,history of diabetes,operation time,preoperative urinary white blood cell level,preoperative albumin level and positive urine culture may be related factors leading to postoperative infection in patients.Early intervention is necessary in clinical practice to address the aforementioned risk factors and improve the prognosis of patients.