Fever after percutaneous nephrolithotomy: contributing factors.
Fever after percutaneous nephrolithotomy: contributing factors.
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DOI：
10.1089/sur.2006.7.367
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发表时间：
2006-09
影响因子：
2
通讯作者：
Farzaneh Sharifi Aghdas;H. Akhavizadegan;A. Aryanpoor;H. Inanloo;M. Karbakhsh
中科院分区：
文献类型：
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作者：
Farzaneh Sharifi Aghdas;H. Akhavizadegan;A. Aryanpoor;H. Inanloo;M. Karbakhsh
背景和目的 经皮手术后发热和尿脓毒症的确切机制尚未确定。本研究研究了经皮肾镜取石术（PCNL）后发热的频率及其影响因素。方法 在一项横断面研究中，2003 年 9 月至 2004 年 3 月期间，所有 217 名在 Labbafinegad 专业泌尿外科中心接受 PCNL 治疗的肾结石患者接受了研究。在手术前、手术中和手术后收集数据。结果 PCNL 后发热频率为 25.8% (n=56)，尽管 62.2% 的病例 (n=135) 未给予预防性抗生素。有发热和无发热患者的平均住院时间分别为 5.4+/-2.3 和 3.4+/-1.7 天 (p=0.001)。发热与女性性别 (p=0.005)、尿培养阳性 (p=0.02) 和肾造口管插入 (p=0.041) 之间观察到显着相关性。其他变量并未被证明是显着的。在逻辑回归分析中，女性性别和肾造口管插入与术后发热独立相关。结论 尽管我们有相当比例的患者没有接受预防性抗生素治疗，但 PCNL 后的发热发生率并不高于文献报道的水平。在鹿角结石手术前仅使用短期抗生素并不会导致发烧率升高。女性发烧的风险更高，可能是因为更容易发生尿路感染。肾造口管与发烧的显着关系可能归因于其作为异物的作用或在更复杂的情况下使用。
BACKGROUND AND PURPOSE The exact mechanism of fever and urosepsis after percutaneous procedures has not been established. This research studied the frequency of fever after percutaneous nephrolithotomy (PCNL) and the contributing factors. METHODS In a cross-sectional study, from September 2003 to March 2004, all 217 patients with nephrolithiasis treated with PCNL at the Labbafinegad Specialized Urology Center were studied. Data were collected before, during, and after surgery. RESULTS The frequency of fever after PCNL was 25.8% (n=56) although in 62.2% of the cases (n=135), no prophylactic antibiotics had been administered. The mean durations of hospitalization in patients with and without fever were 5.4+/-2.3 and 3.4+/-1.7 days, respectively (p=0.001). Significant correlations were observed between fever and female sex (p=0.005), positive urine culture (p=0.02), and nephrostomy tube insertion (p=0.041). Other variables did not prove to be significant. In logistic regression analysis, female sex and nephrostomy tube insertion were independently related to post-operative fever. CONCLUSION Although a considerable proportion of our patients had not received prophylactic antibiotics, the rate of fever after PCNL was no higher than is reported in the literature. Use of only a short course of antibiotics before surgery for staghorn stones did not result in a higher rate of fever. Female sex created a higher risk for fever, probably because of the greater propensity to urinary tract infection. The significant relation of a nephrostomy tube to fever could be attributed to its role as a foreign body or to use in more complicated cases.