【摘要】 目的 本研究旨在探讨上尿路结石术后留置双J管合并尿路感染病原菌特征及影响因素，为临床预防和治疗提供科学依据。方法 通过便利抽样法，收集遵义医科大学附属医院2023年12月至2024年12月的546例因上尿路结石术后留置双J管患者的临床资料，通过电子病历系统，分析尿路感染的发生率、病原菌分布及其影响因素。结果 546例患者中，96例(17.58%)发生尿路感染，均为单一感染。共分离出96株病原菌，其中革兰阴性菌66株(68.75%),以大肠埃希氏菌为主共(29株，30.21%);革兰阳性菌30株(31.25%),以屎肠球菌为主(11株，11.46%)。Logistics回归分析结果显示：残余结石(OR=5.073,95%CI:2.597～9.910)、双J管留置时间(OR=2.066,95%CI:1.385～3.082)、术前尿路感染史(OR=2.664,95%CI:1.290～5.503)、术后尿亚硝酸盐检测结果(OR=8.189,95%CI:3.765～17.812)以及肾积水严重程度(OR=2.971,95%CI:1.675～5.272)被确认为尿路感染的危险因素(P<0.05),而每日饮水量大于3 000 mL(OR=0.393,95%CI:0.223～0.694)则显示为一种保护因素(P<0.05)。结论 上尿路结石术后留置双J管患者合并尿路感染发生率较高，大肠埃希菌为主要病原菌，减少双J管留置时间，增加每日饮水量，术前控制尿路感染及监测亚硝酸盐有助于降低感染风险。更多还原

【Abstract】 Objective This study aims to explore the pathogenic bacteria characteristics and influencing factors of urinary tract infection(UTI) complicated by double J tube indwelling after upper urinary tract stone surgery, so as to provide a scientific basis for clinical prevention and treatment.Methods Using convenience sampling, the clinical data of 546 patients who underwent double J tube placement after upper urinary tract stone surgery in Affiliated Hospital of Zunyi Medical University from December 2023 to December 2024.The electronic medical record system to analyze the incidence of urinary tract infection, the distribution of pathogens, and their influencing factors.Results Among the 546 patients, 96(17.58%) had urinary tract infection, all of which were single infections.A total of 96 pathogens were isolated, including 66 strains of Gram-negative bacteria(68.75%),mainly Escherichia coli(29 strains, 30.21%); 30 strains of Gram-positive bacteria(31.25%),mainly Enterococcus faecium(11 strains, 11.46%).The Logistics regression analysis results showed that residual stones(OR=5.073,95% CI:2.597-9.910),double J tube retention time(OR=2.066,95% CI:1.385-3.082),preoperative UTI history(OR=2.664,95% CI:1.290-5.503),postoperative urine nitrite test results(OR=8.189,95% CI:3.765-17.812),and severity of hydronephrosis(OR=2.971,95% CI:1.675-5.272) were identified as independent risk factors for(UTI)(P<0.05),while daily water intake greater than 3 000 ml(OR=0.393,95% CI:0.223-0.694) was shown as a protective factor(P<0.05).Conclusion The incidence of urinary tract infection is high in patients with double J tube indwelling after upper urinary tract stone surgery, with Escherichia coli as the main pathogen.Reducing the retention time of double J tube, increasing daily water intake, controlling urinary tract infection before surgery and monitoring nitrite can help to reduce the risk of infection.更多还原