【摘要】 目的 探讨肾结石患者经皮肾镜取石术后并发尿路感染的危险因素。方法 行肾结石经皮肾镜取石术患者310例，其中术后尿路感染133例（尿路感染组）和无尿路感染177例（无尿路感染组），收集两组患者临床资料，采用多因素logistic回归分析肾结石患者经皮肾镜取石术后并发尿路感染的危险因素。结果 两组患者的年龄、结石直径、术前尿路感染、预防性使用抗生素、术前尿路梗阻、结石数量、尿管留置时间、术前空腹血糖、术前白蛋白、肾功能障碍、泌尿系统手术史、术前降钙素原（PCT）和CRP水平比较有统计学差异（P<0.05）。多因素logistic分析结果显示，年龄≥60岁、结石直径≥2.5cm、术前有尿路感染、未预防性使用抗生素、术前有尿路梗阻、结石多发、尿管留置时间≥7d、术前空腹血糖≥10mmol/L、术前白蛋白<30g/L、有肾功能障碍、有泌尿系统手术史、术前PCT升高、CRP升高均是肾结石患者经皮肾镜取石术后并发尿路感染的独立危险因素（P<0.05）。结论 肾结石患者经皮肾镜取石术后并发尿路感染的危险因素较多，临床应针对危险因素进行干预，采取合理的康复管理可有效改善患者恢复情况。更多还原

【Abstract】 Objective To explore the risk factors of urinary tract infection in patients with renal calculi after percutaneous nephrolithotomy.Methods Three hundred and ten cases of renal calculi underwent percutaneous nephrolithotomy were divided into two group with 133 cases of postoperative urinary tract infection(urinary tract infection group)and 177 cases without urinary tract infection(no urinary tract infection group).The clinical data of the two groups were collected,and the risk factors of urinary tract infection after percutaneous nephrolithotomy in patients with renal calculi were analyzed by multivariate logistic regression model.Results There were statistically significant differences in age,stone diameter,preoperative urinary tract infection,prophylactic use of antibiotics,preoperative urinary tract obstruction,number of stones,indwelling time of urinary catheter,preoperative fasting blood glucose,preoperative albumin,renal dysfunction,history of urinary system surgery,preoperative procalcitonin(PCT)and CRP levels(P<0.05).Multivariate logistic analysis showed that age≥ 60 years old,stone diameter≥ 2.5 cm,preoperative urinary tract infection,no prophylactic use of antibiotics,preoperative urinary tract obstruction,multiple stones,indwelling time of urinary catheter≥ 7 days,preoperative fasting blood glucose≥ 10 mmol/L,preoperative albumin<30 g/L,renal dysfunction,history of urinary system surgery,elevated preoperative PCT,and elevated preoperative CRP were the independent risk factors for urinary tract infection after percutaneous nephrolithotomy in patients with kidney stones(P<0.05).Conclusion There are many risk factors for urinary tract infection in patients with renal calculi after percutaneous nephrolithotomy.Clinical intervention should be carried out according to the risk factors,and reasonable rehabilitation management can effectively improve the recovery of patients.更多还原