术前尿路白细胞和酸盐的动态变化能否预测培养阳性患者皮肤透神经切除术后的传染性并发症?
Junhao Zheng1, Jiapeng Liu1, Xueqing Zeng1
1Department of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China.
World journal of urology
|January 24, 2026
概括
动态手术前尿液分析有效预测皮肤透神经切除术 (PCNL) 后的感染风险. 持久的阳性尿白细胞 (uWBC) 和酸盐 (NIT) 表明PCNL患者发烧和尿的风险较高.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 皮肤穿神经切除术 (PCNL) 与严重的手术后感染并发症,如发烧和尿道有关.
- 手术前的尿液培养指导了抗生素治疗,但延迟了报告,阻碍了及时的风险评估.
- 现有的尿分析研究往往缺乏对时间趋势的系统评估.
研究的目的:
- 调查手术前尿白细胞 (uWBC) 和亚酸盐 (NIT) 的时间变化与PCNL患者手术后发烧和尿液的风险之间的关联.
- 确定动态尿分析趋势是否可以改善手术前感染风险分层.
主要方法:
- 一项前性观察性研究包括346名接受PCNL的培养阳性患者.
- 在入院和手术前一天早上进行了UWBC和NIT的尿液分析.
- 根据uWBC和NIT的趋势对患者进行了分类;逻辑回归分析了与传染性结果的关联.
主要成果:
- 手术后发烧发生在20.8%的患者中,尿道发生在3.2%的患者中.
- 持续呈阳性或增加uWBC独立预测的手术后发烧 (OR 1.95-2.62).
- 持久的阳性NIT独立预测尿 (OR 7.32) 和发烧 (OR 2.41).
结论:
- 动态手术前尿分析为PCNL候选人感染风险分层提供了一种简单,具有成本效益的方法.
- 在uWBC中缺乏改善或持久的阳性和持久的阳性NIT确定高风险患者.
- 将动态尿分析与临床因素相结合,可以增强术前风险分层和感染预防策略.
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