经皮肾镜取石术前尿培养与术后全身炎症反应综合征的关系-论文.pdf

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1、临床泌尿外科杂志2014正·1O6·JClinUrology(China)29卷2期经皮肾镜取石术前尿培养与术后全身炎症反应综合征的关系熊海云曾小明余明主谭公祥陈亚梅郑慧杰周刚标[摘要]目的：探讨经皮肾镜取石术(PCNI)术前中段尿培养与术后全身炎症反应综合征(SIRS)之间的关系。方法：回顾性分析2010年1月～2013年6月应用超声引导下经皮肾镜气压弹道联合超声碎石术治疗患者的临床资料，所有病例术前均常规行中段尿细菌培养和使用抗生素，分析评价术前中段尿培养与术后SIRS之间的关系。结果：纳入

2、分析97例，中段尿培养阳性者2O例。PCNL术后发生SIRS者共17例，其中，术前中段尿培养阳性者6例，阴性者l1例。中段尿培养阳性患者术后SIRS发生率与阴性者相比，差异无统计学意义(P>0．05)。以尿培养来判断SIRS的灵敏度为35．3。结论：在应用抗生素情况下，PCNL术前中段尿培养同术后SIRS的发生之问无明显相关性，不是有效的预测指标。[关键词]经皮肾镜取石术；尿培养；全身炎症反应综合征doi：10．13201／j．issn．1001—1420．2014．02．005[中图分类号]R

3、693．4[文献标识码]ACorrelationsbetweenpreoperativemid-streamurinecultureandpostoperativesystemicinflammatoryresponsesyndromeofpercutaneousnephrolithotomyXIONGHaiyunZENGXiaomingYUMingzhuTANGongxiangCHENYameiZHENGHuiiieZH0UGangbiao(DepartmentofUrology，94thHo

4、spitalofPLA，Nanchang，330002，China)Correspondingauthor：ZENGXiaoming，E—mail：zengxm94@126．cornAbstractObjective：Toexploretherelationshipbetweenpreoperativemid—streamurinecultureandpostoper—ativesystemicinflammatoryresponsesyndrome(SIRS)ofpercutaneousnep

5、hrolithotomy．Method：Aretrospec—tiveanalysisofpatientsunderwentPCNLfromJanuary2010tOJune2013wasperformed．Preoperativemid—streamurineculturesweredoneandantibioticswereusedinallpatients．Therelationshipbetweenpreoperativemid—streamurinecultureandpostoper

6、ativeSIRSwasevaluated．Result：Therewere97patientsinthisstudy．Twentypatientshadapositiveurinecultureand17patientsdevelopedSIRS．SixpatientshadapositiveculturewhodevelopedSIRSlater．Therewasnostatisticaldifferencebetweenpositiveandnegativeurineculturegrou

7、psintermsofSIRS(P>0．05)．ThesensitivityofusingurineculturetOdeterminetheonsetofSIRSwas35．3．Conclusion：Thereisnoobviouscorrelationbetweenpreoperativemid—streamurinecultureandpostoperativeSIRSinpatientsundergoingpereutaneousnephrolithotomywhenantibiotic

8、sused．PositivepreoperativeurineisnotanefficientindicatorofpredictingSIRS．Keywordspercutaneousnephrolithotomy；urineculture；systemicinflammatoryresponsesyndrome经皮肾镜取石术(PCNL)已经成为目前治疗的发生尚有争议，结果不尽一致。“。为进一步探巨大肾和输尿管上段结石的首选，虽属微创手术，讨PCNL术前中段尿培养与术后发生SIRS之间也会出现