经皮肾镜取石术后并发尿源性脓毒血症的影响因素研究进展
Research Progress on Influencing Factors of Urinary Sepsis after Percutaneous Nephrolithotomy
DOI: 10.12677/acm.2025.1572013, PDF,    科研立项经费支持
作者: 陈 涛, 陈 戬*, 崔茂璨, 杨轶哲, 徐铭鸿：昆明医科大学第二附属医院泌尿外科，云南 昆明；陈丽萍：昆明医科大学第二附属医院手术室，云南 昆明
关键词: 泌尿系结石；经皮肾镜取石术；尿源性脓毒血症；并发症；危险因素；Urolithiasis； Percutaneous Nephrolithotomy； Urinary Sepsis； Complications； Risk Factors
摘要: 泌尿系结石是泌尿外科常见病、多发病之一。经皮肾镜取石术(Percutaneous nephrolithotomy, PCNL)是治疗泌尿系结石常用的手术方式。感染是PCNL术后最严重的并发症之一，其包括发热、全身炎症反应综合征(SIRS)、尿源性脓毒血症及感染性休克。尿源性脓毒血症是一种严重的全身反应综合征，其预后极差，如果处理不当，可能会对患者的生命构成严重威胁，因此预防PCNL后尿源性脓毒血症的发生至关重要。本文将对PCNL后并发尿源性脓毒血症的影响因素进行综述。
Abstract: Urolithiasis is one of the common and frequently occurring diseases in urology. Percutaneous nephrolithotomy (PCNL) is a common surgical method for the treatment of urolithiasis. Infection is one of the most serious complications after PCNL, including fever, systemic inflammatory response syndrome (SIRS), urinary sepsis and septic shock. Urinary sepsis is a serious systemic response syndrome with a very poor prognosis. If not treated properly, it may pose a serious threat to the patient’s life. Therefore, it is very important to prevent the occurrence of urinary sepsis after PCNL. This article will review the influencing factors of urinary sepsis after PCNL.
文章引用：陈涛, 陈丽萍, 陈戬, 崔茂璨, 杨轶哲, 徐铭鸿. 经皮肾镜取石术后并发尿源性脓毒血症的影响因素研究进展[J]. 临床医学进展, 2025, 15(7): 480-486. https://doi.org/10.12677/acm.2025.1572013

参考文献

[1] Tan, S., Yuan, D., Su, H., Chen, W., Zhu, S., Yan, B., et al. (2023) Prevalence of Urolithiasis in China: A Systematic Review and Meta‐Analysis. BJU International, 133, 34-43. [Google Scholar] [CrossRef] [PubMed]
[2] 庄浩铨, 徐煜宇, 徐桂彬. 经皮肾精准穿刺技术相关进展[J]. 现代泌尿外科杂志, 2022, 27(2): 168-172.
[3] Türk, C., Petřík, A., Sarica, K., Seitz, C., Skolarikos, A., Straub, M., et al. (2016) EAU Guidelines on Interventional Treatment for Urolithiasis. European Urology, 69, 475-482. [Google Scholar] [CrossRef] [PubMed]
[4] Labate, G., Modi, P., Timoney, A., Cormio, L., Zhang, X., Louie, M., et al. (2011) The Percutaneous Nephrolithotomy Global Study: Classification of Complications. Journal of Endourology, 25, 1275-1280. [Google Scholar] [CrossRef] [PubMed]
[5] Singh, P., Yadav, S., Singh, A., Saini, A.K., Kumar, R., Seth, A., et al. (2016) Systemic Inflammatory Response Syndrome Following Percutaneous Nephrolithotomy: Assessment of Risk Factors and Their Impact on Patient Outcomes. Urologia Internationalis, 96, 207-211. [Google Scholar] [CrossRef] [PubMed]
[6] O’keeffe, N.K., Mortimer, A.J., Sambrook, P.A. and Rao, P.N. (1993) Severe Sepsis Following Percutaneous or Endoscopic Procedures for Urinary Tract Stones. British Journal of Urology, 72, 277-283. [Google Scholar] [CrossRef] [PubMed]
[7] Zhou, G., Zhou, Y., Chen, R., Wang, D., Zhou, S., Zhong, J., et al. (2022) The Influencing Factors of Infectious Complications after Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis. Urolithiasis, 51, Article No. 17. [Google Scholar] [CrossRef] [PubMed]
[8] Yoshimura, K., Utsunomiya, N., Ichioka, K., Ueda, N., Matsui, Y. and Terai, A. (2005) Emergency Drainage for Urosepsis Associated with Upper Urinary Tract Calculi. Journal of Urology, 173, 458-462. [Google Scholar] [CrossRef] [PubMed]
[9] Chugh, S., Pietropaolo, A., Montanari, E., Sarica, K. and Somani, B.K. (2020) Predictors of Urinary Infections and Urosepsis after Ureteroscopy for Stone Disease: A Systematic Review from EAU Section of Urolithiasis (Eulis). Current Urology Reports, 21, Article No. 16. [Google Scholar] [CrossRef] [PubMed]
[10] Alhabeeb, H., Baradwan, S., Kord-Varkaneh, H., Tan, S.C., Low, T.Y., Alomar, O., et al. (2021) Association between Body Mass Index and Urinary Tract Infection: A Systematic Review and Meta-Analysis of Observational Cohort Studies. Eating and Weight Disorders—Studies on Anorexia, Bulimia and Obesity, 26, 2117-2125. [Google Scholar] [CrossRef] [PubMed]
[11] Gutierrez, J., Smith, A., Geavlete, P., Shah, H., Kural, A.R., de Sio, M., et al. (2012) Urinary Tract Infections and Post-Operative Fever in Percutaneous Nephrolithotomy. World Journal of Urology, 31, 1135-1140. [Google Scholar] [CrossRef] [PubMed]
[12] Rashid, A.O. and Fakhralddin, S.S. (2016) Risk Factors for Fever and Sepsis after Percutaneous Nephrolithotomy. Asian Journal of Urology, 3, 82-87. [Google Scholar] [CrossRef] [PubMed]
[13] Zhu, L., Jiang, R., Pei, L., Li, X., Kong, X. and Wang, X. (2020) Risk Factors for the Fever after Percutaneous Nephrolithotomy: A Retrospective Analysis. Translational Andrology and Urology, 9, 1262-1269. [Google Scholar] [CrossRef] [PubMed]
[14] Rivera, M., Viers, B., Cockerill, P., Agarwal, D., Mehta, R. and Krambeck, A. (2016) Pre-and Postoperative Predictors of Infection-Related Complications in Patients Undergoing Percutaneous Nephrolithotomy. Journal of Endourology, 30, 982-986. [Google Scholar] [CrossRef] [PubMed]
[15] Shin, T.S., Cho, H.J., Hong, S., Lee, J.Y., Kim, S.W. and Hwang, T. (2011) Complications of Percutaneous Nephrolithotomy Classified by the Modified Clavien Grading System: A Single Center’s Experience over 16 Years. Korean Journal of Urology, 52, Article No. 769. [Google Scholar] [CrossRef] [PubMed]
[16] 孙颖浩. 吴阶平泌尿外科学[M]. 北京: 人民卫生出版社, 2019.
[17] McAleer, I.M., Kaplan, G.W., Bradley, J.S., Carroll, S.F. and Griffith, D.P. (2003) Endotoxin Content in Renal Calculi. Journal of Urology, 169, 1813-1814. [Google Scholar] [CrossRef] [PubMed]
[18] Wang, L., Li, D., He, W., Shi, G., Zhai, J., Cen, Z., et al. (2024) Development and Validation of a Predictive Model for Post-Percutaneous Nephrolithotomy Urinary Sepsis: A Multicenter Retrospective Study. Minerva Urology and Nephrology, 76, 357-366. [Google Scholar] [CrossRef] [PubMed]
[19] Dogan, H.S., Guliyev, F., Cetinkaya, Y.S., Sofikerim, M., Ozden, E. and Sahin, A. (2007) Importance of Microbiological Evaluation in Management of Infectious Complications Following Percutaneous Nephrolithotomy. International Urology and Nephrology, 39, 737-742. [Google Scholar] [CrossRef] [PubMed]
[20] Yang, Z., Lin, D., Hong, Y., Hu, M., Cai, W., Pan, H., et al. (2022) The Effect of Preoperative Urine Culture and Bacterial Species on Infection after Percutaneous Nephrolithotomy for Patients with Upper Urinary Tract Stones. Scientific Reports, 12, Article No. 4833. [Google Scholar] [CrossRef] [PubMed]
[21] Qiu, Z., Zhan, S., Song, Y., Huang, L., Xie, J., Qiu, T., et al. (2024) Construction and Validation of the Nomogram Predictive Model for Post-Percutaneous Nephrolithotomy Urinary Sepsis. World Journal of Urology, 42, Article No. 135. [Google Scholar] [CrossRef] [PubMed]
[22] Zhou, L., Zhang, C., Zhan, X., Li, M., Luo, N., Wu, W., et al. (2024) Effect of Intrarenal Pelvic Pressure on Pyelo-Tubular Backflow and Renal Cortical Blood Perfusion during Mini-Percutaneous Nephrolithotomy. World Journal of Urology, 42, Article No. 595. [Google Scholar] [CrossRef] [PubMed]
[23] Guo, H.Q., Shi, H.L., Li, X.G., Gan, W.D., Zeng, L.Q., et al. (2008) Relationship between the Intrapelvic Perfusion Pressure in Minimally Invasive Percutaneous Nephrolithotomy and Postoperative Recovery. Chinese Journal of Surgery, 46, 52-54.
[24] Flannigan, R., Choy, W.H., Chew, B. and Lange, D. (2014) Renal Struvite Stones—Pathogenesis, Microbiology, and Management Strategies. Nature Reviews Urology, 11, 333-341. [Google Scholar] [CrossRef] [PubMed]
[25] Kukreja, R., Desai, M., Patel, S., Bapat, S. and Desai, M. (2004) First Prize: Factors Affecting Blood Loss during Percutaneous Nephrolithotomy: Prospective Study. Journal of Endourology, 18, 715-722. [Google Scholar] [CrossRef] [PubMed]
[26] Guddeti, R.S., Hegde, P., Chawla, A., de la Rosette, J.J.M.C.H., Laguna Pes, M.P. and Kapadia, A. (2020) Super‐Mini Percutaneous Nephrolithotomy (PCNL) vs Standard PCNL for the Management of Renal Calculi of < 2 cm: A Randomised Controlled Study. BJU International, 126, 273-279. [Google Scholar] [CrossRef] [PubMed]
[27] 洪涛, 柯莽, 俞洪元, 等. 不同口径通道对经皮肾镜取石手术患者术后感染的影响[J]. 中华医院感染学杂志, 2017, 27(7): 1568-1571.
[28] 潘铁军, 谢旭敏, 李功成. 不同口径通道经皮肾镜取石术与术后感染的相关性研究[J]. 现代泌尿外科杂志, 2015, 20(3): 147-150.
[29] Ng, C. (2014) Training in Percutaneous Nephrolithotomy: The Learning Curve and Options. Arab Journal of Urology, 12, 54-57. [Google Scholar] [CrossRef] [PubMed]
[30] Allen, D., O’Brien, T., Tiptaft, R. and Glass, J. (2005) Defining the Learning Curve for Percutaneous Nephrolithotomy. Journal of Endourology, 19, 279-282. [Google Scholar] [CrossRef] [PubMed]
[31] Schilling, D., Gakis, G., Walcher, U., Stenzl, A. and Nagele, U. (2010) The Learning Curve in Minimally Invasive Percutaneous Nephrolitholapaxy: A 1-Year Retrospective Evaluation of a Novice and an Expert. World Journal of Urology, 29, 749-753. [Google Scholar] [CrossRef] [PubMed]
[32] Moosanejad, N., Firouzian, A., Hashemi, S.A., Bahari, M. and Fazli, M. (2016) Comparison of Totally Tubeless Percutaneous Nephrolithotomy and Standard Percutaneous Nephrolithotomy for Kidney Stones: A Randomized, Clinical Trial. Brazilian Journal of Medical and Biological Research, 49. [Google Scholar] [CrossRef] [PubMed]

为你推荐