Analysis of the risk factors of fever after ureteroscopic holmium laser lithotripsy

doi:10.3877/cma.j.issn.1674-3253.2019.02.005

Abstract

Abstract:

Objective

To explore the risk factors of fever after ureteroscopic holmium laser lithotripsy for ureteral calculi.

Methods

568 patients with ureteral calculi and received ureteroscopic holmium laser lithotripsy in our hospital from Jan 2013 to Dec 2016 were selected in this study. Investigate the risk factors of fever after ureteroscopic holmium laser lithotripsy in ureteral calculi patients.

Results

After the operation, 60 cases of fever were found (10.56%). Risk factors of fever in patients with ureteral calculi after ureteroscopic holmium laser lithotripsy were female (OR=1.266, 95%CI=1.106~1.865, P=0.02), preoperative uric leukocytosis (OR=2.296, 95%CI=1.856~5.156, P<0.01), preoperative urine bacterial culture positive (OR=1.115, 95%CI=1.005~1.568, P<0.01), long perfusion time (OR=1.226, 95%CI=1.098~1.704, P=0.03), long operative time (OR=1.328, 95%CI=1.167~1.969, P=0.03).

Conclusion

For women patients with preoperative uric leukocytosis, preoperative positive urine culture, long infusion time, long operation time, we should pay attention to prevention and treatment of fever after ureteroscopic holmium laser lithotripsy.

Key words: Ureteroscopy, Holmium laser, Ureteral calculi, Fever, Multivariate logistic regression analysis

Fei Gao, Lin Luo. Analysis of the risk factors of fever after ureteroscopic holmium laser lithotripsy[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(02): 91-94.

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URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2019.02.005

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References 13

[1]	Schmidt S,Miernik A. Alpha-blockers as medical expulsive therapy for ureteral stones[J]. Urologe A, 2016, 55(6): 813-816.
[2]	叶照华,米其武,罗杰鑫，等. 输尿管结石行输尿管镜下碎石术后并发输尿管狭窄的危险因素分析[J]. 中华腔镜泌尿外科杂志(电子版)，2017，11(1): 46-48.
[3]	Ercil H,Alma E,Bas O, et al. Safety and efficacy of pneumatic lithotripters versus holmium laser on multiple ureteral calculi[J]. Arch Iran Med, 2016, 19(11): 786-790.
[4]	张立进,吴斌,查振雷,等. 后腹腔镜下输尿管切开取石术与输尿管软镜钬激光碎石术治疗复杂性上段输尿管结石的效果分析[J]. 中华外科杂志，2017，55(10): 751-754.
[5]	陶宏平,赵伟平,朱扬进,等. 经输尿管硬镜钬激光碎石术与气压弹道碎石术治疗输尿管多发结石的临床研究[J]. 中国内镜杂志，2016，22(4): 39-42.
[6]	Hsieh CH,Yang SD,Lin CD, et al. Are prophylactic antibiotics necessary in patients with preoperative sterile urine undergoing ureterorenoscopic lithotripsy?[J]. Bju Int, 2014, 113(2): 275-280.
[7]	de la Rosette J,Denstedt J,Geavlete P, et al. The clinical research office of the endourological society ureteroscopy global study: indications, complications, and outcomes in 11885 patients[J]. J Endourol, 2014, 28(2): 131-139.
[8]	席启林,欧阳骏,侯建全,等. 输尿管镜钬激光碎石术治疗输尿管结石术后发热相关因素分析[J]. 临床泌尿外科杂志，2015(6): 518-520.
[9]	王家勇. 微创经皮肾镜碎石取石术后发热的相关危险因素分析[J]. 中国实用医刊, 2016, 43(22): 114-115.
[10]	中国女医师协会肾脏病与血液净化专委会. 中国女性尿路感染诊疗专家共识[J]. 中华医学杂志, 2017, 97(36): 2827-2832.
[11]	邓小林,宋乐明,钟久庆,等. 可智能监控肾盂内压的输尿管软镜吸引取石术的临床应用[J]. 中华泌尿外科杂志，2016，37(5): 385-388.
[12]	Mandal S,Goel A,Singh M K, et al. Clavien classification of semirigid ureteroscopy complications: a prospective study[J]. Urology, 2012, 80(5): 995-1001.
[13]	陈柏君. 微创经皮肾镜碎石术术后结石残留的相关因素分析[J]. 中华全科医学, 2016, 14(5): 869-871.

组别	例数	性别（例）		年龄（岁，±s ）	BMI （kg/m²，±s ）	吸烟（例）	嗜酒（例）	糖尿病（例）	高血压（例）
组别	例数	男	女	年龄（岁，±s ）	BMI （kg/m²，±s ）	吸烟（例）	嗜酒（例）	糖尿病（例）	高血压（例）
发热	60	22	38	51±18	24.9±1.3	11	10	11	13
未发热	508	302	206	50±18	25.1±1.3	104	97	100	112
统计值	?	χ²=11.37		t=-0.54	0t=1.16	χ²=0.15	χ²=0.21	χ²=0.06	χ²=0.05
P值	?	<0.01		-0.59	000.25	0.7	0.65	0.80	0.95
因素	高血脂（例）	结石位置（例）			结石数量（例）		结石部位（例）				结石直径（mm，±s ）	肾积水程度（例）
		结石位置（例）			结石数量（例）		结石部位（例）					左	右	双侧	单发	多发	上端	中端	下端	多个部位	轻度	中度	重度
		发热	12	24	26	10	21	39	4	9		8	39	13±5	32	18	10
未发热	124	175	202	131	190	318	35	75	80	318	10±4	310	105	93
统计值	χ²=0.57	χ²=0.25			χ²=0.13		χ²=0.44				t=-3.86	χ²=0.55
P值	0.45	0.68			0.72		0.51				<0.01.	0.48
因素	术前尿白细胞计数（个/μl，±s ）	术前尿培养细菌（例）		术前预防使用抗生素（例）	灌注时间（min，±s ）	手术时间（min，±s ）	术中出血量（ml，±s ）
因素	术前尿白细胞计数（个/μl，±s ）	阳性	阴性	术前预防使用抗生素（例）	灌注时间（min，±s ）	手术时间（min，±s ）	术中出血量（ml，±s ）
发热	42±10	15	45	4	104±31	69±21	357±103
未发热	21±9	70	438	311	082±24	54±19	290±113
统计值	t=-15.59	χ²=5.31		χ²=64.65	t=-5.39	t=-5.12	t=-4.77
P值	.<0.001	0.02		<0.001	<0.001	<0.001	<0.001

组别	例数	性别（例）		年龄（岁，±s ）	BMI （kg/m²，±s ）	吸烟（例）	嗜酒（例）	糖尿病（例）	高血压（例）
组别	例数	男	女	年龄（岁，±s ）	BMI （kg/m²，±s ）	吸烟（例）	嗜酒（例）	糖尿病（例）	高血压（例）
发热	60	22	38	51±18	24.9±1.3	11	10	11	13
未发热	508	302	206	50±18	25.1±1.3	104	97	100	112
统计值	?	χ²=11.37		t=-0.54	0t=1.16	χ²=0.15	χ²=0.21	χ²=0.06	χ²=0.05
P值	?	<0.01		-0.59	000.25	0.7	0.65	0.80	0.95
因素	高血脂（例）	结石位置（例）			结石数量（例）		结石部位（例）				结石直径（mm，±s ）	肾积水程度（例）
		结石位置（例）			结石数量（例）		结石部位（例）					左	右	双侧	单发	多发	上端	中端	下端	多个部位	轻度	中度	重度
		发热	12	24	26	10	21	39	4	9		8	39	13±5	32	18	10
未发热	124	175	202	131	190	318	35	75	80	318	10±4	310	105	93
统计值	χ²=0.57	χ²=0.25			χ²=0.13		χ²=0.44				t=-3.86	χ²=0.55
P值	0.45	0.68			0.72		0.51				<0.01.	0.48
因素	术前尿白细胞计数（个/μl，±s ）	术前尿培养细菌（例）		术前预防使用抗生素（例）	灌注时间（min，±s ）	手术时间（min，±s ）	术中出血量（ml，±s ）
因素	术前尿白细胞计数（个/μl，±s ）	阳性	阴性	术前预防使用抗生素（例）	灌注时间（min，±s ）	手术时间（min，±s ）	术中出血量（ml，±s ）
发热	42±10	15	45	4	104±31	69±21	357±103
未发热	21±9	70	438	311	082±24	54±19	290±113
统计值	t=-15.59	χ²=5.31		χ²=64.65	t=-5.39	t=-5.12	t=-4.77
P值	.<0.001	0.02		<0.001	<0.001	<0.001	<0.001

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