【摘要】 目的:比较上尿路结石患者术前尿培养及术中肾盂尿、结石培养结果,探讨围手术期全身炎症反应综合征(SIRS)的影响因素。方法:收集210例行经皮肾镜手术(PCNL)患者临床资料,术前均留取中段尿培养,术中留取肾盂尿,采用标准化Stamey法留取结石标本,分别行细菌培养,对术后发生SIRS者依据结石培养结果选择抗生素。根据术后是否发生SIRS分为A组和B组。结果:年龄、结石大小、手术时间、性别、体质量指数、结石取石成功率等在两组中无明显统计学差异。术前尿培养、肾盂尿培养及结石培养在A组的阳性率分别为66.7%、46.7%、44.4%,其中3例发生感染性休克,3种培养均为阳性;在B组中的阳性率分别为13.9%、6.1%、5.5%。结论:术前尿培养、术中肾盂尿培养及结石培养对术后SIRS的发生起到很好地预测作用,术中肾盂尿及结石培养对术后抗生素的选择提供依据。更多还原

【Abstract】 Objective:To predict the impact factors for preoperative and intraoperative occurrence of systemic inflammatory response syndrome(SIRS)comparing the pre-surgery patients with urinary calculi,pelvis surgery urine culture and stone culture results were compared.Methods:Two hundred and ten patients underwent percutaneous nephrolithotomy surgery and preoperative urine culture specimens,intraoperative urine specimens from the renal pelvis,bacterial specimens stone specimens were studied using a standardized method.Stamey cultivation of postoperative SIRS culture results were based on calculus choice of antibiotics.Postoperative SIRS(A group)had 45 cases(21.4%)and SIRS(group B)165 patients(78.5%)were divided according to the results.Results:Age,stone size,operation time,gender,body mass index,stone success rate were not significantly different in both groups;preoperative urine culture,renal pelvis urine culture and stones culture positive rate in group A were 66.7%,46.7%,44.4%,respectively;Positive rates in group B were 13.9%,6.1%,5.5%,respectively;three cases had septic shock and all cultures were positive.Conclusion:Preoperative urine culture,pelvis surgery urine culture and stone culture have a very good predictive function on postoperative SIRS and pelvis surgery urine culture and stone cultures can be a good choice for selecting antibiotics.更多还原