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目的:探讨引起输尿管镜钬激光碎石术治疗输尿管结石术后发热的相关因素。方法:回顾性分析2011年1月~2013年12月我院输尿管镜钬激光碎石治疗输尿管结石683例患者的临床资料,包括年龄、性别、合并糖尿病病史、合并高血压病病史、既往同侧结石手术史、结石患侧、结石部位、结石最长径、术前尿常规白细胞计数、术前存在发热史、术前尿培养结果、肾积水程度、术前预防性应用抗生素和手术时间,分析各参数与术后发热的关联性。结果:683例患者中术后发热共38例。性别比例、结石长径、手术时间、术前尿常规白细胞计数、术前发热比例和术前尿细菌培养阳性率在两组间比较,差异均有统计学意义(P<0.05);Logistic单因素分析显示,女性、结石负荷大、手术时间长、术前尿液白细胞计数高、术前发热史和尿细菌培养阳性是术后发热的高危因素(OR>1,P<0.05);Logistic多因素分析显示,手术时间长、术前发热史和尿细菌培养阳性是术后发热的独立危险因素(OR>1,P<0.05)。结论:输尿管镜钬激光碎石手术前需常规做尿细菌培养,彻底治疗尿路感染,合理缩短手术时间,以降低术后患者发热的发生率。
Objective: To investigate the related factors of fever after ureteroscopic holmium laser lithotripsy. Methods: The clinical data of 683 patients with ureteral calculi treated with ureteroscopic holmium laser in our hospital from January 2011 to December 2013 were retrospectively analyzed. The data included age, sex, history of diabetes mellitus, history of hypertension, previous ipsilateral Preoperative preoperative exothermic history, preoperative urinary culture results, hydronephrosis, preoperative prophylactic use of antibiotics and operation time, preoperative urinary albumin, preoperative fever history, preoperative urine culture, hydronephrosis, Analysis of the correlation between parameters and postoperative fever. Results: There were 38 cases of postoperative fever in 683 patients. There were significant differences between the two groups in sex ratio, length of the stone, operation time, preoperative urinary routine white blood cell count, preoperative fever ratio and preoperative urine bacterial culture positive rate in both groups (P <0.05); Logistic single factor The analysis showed that the risk factors for postoperative fever were high risk of postoperative fever in women with large stone load, long operation time, high preoperative urine leukocyte count, preoperative fever history and positive urine bacterial culture (P> 0.05). Logistic multiple factors Analysis showed that long operation time, preoperative fever history and urine culture positive were independent risk factors for postoperative fever (OR> 1, P <0.05). Conclusion: Ureteroscopic holmium laser lithotripsy before routine surgery to do urinary bacterial culture, a thorough treatment of urinary tract infection, a reasonable shortening of operative time to reduce the incidence of postoperative fever.