【摘要】 目的 探讨负压吸引清石鞘辅助经皮肾镜取石术(PCNL)应用于肾结石的治疗效果，分析术后并发感染的影响因素。方法 2020年1月～2022年10月我院收治并行PCNL术的肾结石病人260例，根据术中是否应用负压清石鞘分为负压吸引组(118例)与对照组(142例),统计两组基线资料、围术期及术后并发症情况。根据术后是否并发感染分为感染组与未感染组，重新校正两组资料，采用多因素Logistic回归模型分析影响肾结石病人PCNL术后并发感染的相关因素。结果 两组性别、年龄、体质指数(BMI)、结石位置、结石长径等基线资料比较差异无统计学意义(P>0.05),两组手术时间、术中出血量以及结石清除率等比较，差异无统计学意义(P>0.05)。负压吸引组术后住院时间短于对照组，差异有统计学意义(P<0.05);负压吸引组和对照组术后血常规异常发生率分别为6.78%、17.61%,全身系统炎症综合征(SIRS)发生率分别为5.08%、14.08%,两组比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示：BMI≥25 kg/m~2(OR=4.329)、合并糖尿病(OR=3.096)、结石直径≥3.0 cm为影响肾结石病人PCNL术后并发感染的独立危险因素((OR=2.905,P<0.05),负压吸引清石鞘为肾结石病人PCNL术后并发感染的保护因素((OR=0.305,P<0.05)。结论 负压吸引清石鞘辅助PCNL术应用于肾结石病人，能够明显降低病人术后感染发生率，有利于术后快速恢复。BMI≥25 kg/m~2、伴糖尿病、结石直径≥3.0 cm为术后并发感染的危险因素。更多还原

【Abstract】 Objective To investigate the therapeutic effect and postoperative complications of negative pressure suction stone clearing sheath assisted percutaneous nephrolithotomy(PCNL) applied to kidney stones, and to analyze the influence of postoperative complicated infection.Methods The clinical data of 260 renal stone patients who underwent PCNL in our hospital from January 2020 to October 2022 were reviewed, divided into negative pressure suction group(118 cases) versus control group(142 cases) according to whether negative pressure stone clearing sheath was applied intraoperatively, and the baseline data, perioperative conditions as well as postoperative complications were statistically compared between the two groups.We further divided the infected group into infected group vs.uninfected group according to whether postoperative intercurrent infection was observed, and the data of the two groups were recalibrated, and multivariate logistic regression model was used to analyze the factors related to postoperative intercurrent infection after PCNL in patients with renal stones.Results There were no significant differences in baseline data such as gender, age, BMI,stone location, and stone length diameter between the two groups(P>0.05),and there were no significant differences in perioperative conditions such as operation time, intraoperative blood loss, and stone clearance rate(P>0.05).However, the postoperative hospital stay in the negative pressure suction group was shorter than that in the control group(P<0.05).The incidence of abnormal blood routine [6.78%(8/118) vs.17.61%(25/142)] and SIRS [5.08%(6/118) vs.14.08%(20/142)] in the negative pressure suction group were lower than those in the control group(P<0.05).Multivariate Logistic regression analysis showed that: BMI≥25 kg/m~2(OR=4.329),diabetes mellitus(OR=3.096),stone diameter ≥3.0 cm(OR=2.905) were independent risk factors for postoperative infection in patients with renal calculi after PCNL(P<0.05).Negative pressure suction of stone sheath(OR=0.305) was a protective factor for postoperative infection in patients with renal calculi after PCNL(P<0.05).Conclusion PCNL assisted by negative pressure suction Qingshi sheath can significantly reduce the incidence of postoperative infection in patients with kidney stones, and is conducive to rapid postoperative recovery.BMI≥25 kg/m~2,diabetes mellitus and stone diameter ≥3.0 cm are risk factors for postoperative infection.更多还原