经皮肾镜取石术后发热的危险因素和防治措施
| 作者: |
1王光春,
1朱崴,
1黄建华,
1刘敏,
1耿江,
1鄢阳,
1车建平,
1牛晓振,
1申佩军,
1彭波,
1许云飞,
1姚旭东,
1郑军华
1 同济大学附属第十人民医院泌尿外科，上海 200072 |
| 通讯: |
郑军华
Email: zhengjh0471@sina.com |
| DOI: | 10.3978/j.issn.2095-6959.2015.04.011 |
摘要
目的：探讨经皮肾镜取石术(percutaneous nephrolithotomy，PCNL)术后发热的危险因素及其防治 措施。方法：回顾性分析2009年9月~2013年6月在我科行PCNL的369例患者的临床资料，根据术后 有无发热(体温>38.5 ℃)分为术后发热组和未发热组，分别分析PCNL术后发热的各种危险因素， 并探讨其有效防治措施。结果：PCNL术后发热45例，其发生率为12.2%；发热与术前尿培养阳 性、脓肾、结石表面积>6 cm2、术中出血量>400 mL、手术时间>90 min、灌注液量>30 L、引流不 畅等因素有关(P<0.05)。结论：发热是PCNL术后常见的并发症，术前有效控制尿路感染、合理预 防性使用抗生素、正确掌握手术时机、控制手术时间、无菌操作、保持引流通畅是防治PCNL术后 发热的有效措施。
关键词：
经皮肾镜取石术
发热
危险因素
防治措施
Risk factors of postoperative fever in percutaneous nephrolithotomy and optimal treatment strategy
CorrespondingAuthor: ZHENG Junhua Email: zhengjh0471@sina.com
DOI: 10.3978/j.issn.2095-6959.2015.04.011
Abstract
Objective: To investigate the risk factors of postoperative fever in percutaneous nephrolithotomy (PCNL) and explore optimal treatment strategy. Methods: A total of 369 patients who underwent PCNL in our center from September 2009 to June 2013 were retrospectively analyzed and divided into two groups: fever group (T >38.5 ℃) and non-fever group (T ≤38.5 ℃). Analyses for the risk factors of fever were performed. Results: Of 369 PCNL patients, 45 (12.2%) cases suffered from postoperative fever. Urinary tract infection, pyonephrosis, stone surface area > 6 cm2, bleeding volume >400 mL, operation time >2 min, irrigation fluid volume >30 L and inadequate drainage were risk factors of postoperative fever (P<0.05). Conclusion: Fever is the common postoperative complication of PCNL. Effective control of urinary tract infections, rational use of prophylactic antibiotics, optimal timing of surgery, aseptic processing and unobstructed drainage should be performed to prevent and treat the PCNL postoperative fever.