输尿管软镜碎石术前尿培养与术后全身性炎症反应综合征的关系

目的探讨输尿管软镜碎石术术前中段尿培养与术后全身性炎症反应综合征（SIRS）之间的关系。方法回顾性分析2012年1月至2014年2月应用输尿管软镜碎石术治疗肾结石患者的临床资料,所有病例术前均常规行中段尿细菌培养和使用抗生素,分析评价术前中段尿培养与术后SIRS之间的关系。结果纳入分析105例,中段尿培养阳性者22例。输尿管软镜碎石术术后发生SIRS者共18例,其中,术前中段尿培养阳性者7例,阴性者11例。中段尿培养阳性患者术后发生SIRS率与阴性者相比,差异无统计学意义（P〉0.05）。以尿培养来判断SIRS的灵敏度为38.8%。结论在应用抗生素情况下,输尿管软镜碎石术术前中段尿培养同术后SIRS的发生之间无明显相关性,不是有效的预测指标。

Relationship between Preoperative Urine Culture and Postoperative Systemic Inflammatory Response Syndrome in Lithotripsy under Flexible Ureteroscope

Objective To investigate the relationship between preoperative urine culture and postoperative systemic inflammatory response syndrome（SIRS）in lithotripsy under flexible ureteroscope.Methods A retrospective analysis was performed in patients who underwent lithotripsy under flexible ureteroscope for renal calculi between January 2012and February 2014.Midstream urine culture was performed and antibiotics were used before lithotripsy.The relationship between preoperative midstream urine culture and postoperative SIRS was analyzed.Results A total of 105cases were included in the study and midstream urine culture was positive in 22cases.Among the 18patients who had SIRS after lithotripsy,preoperative urine culture was positive in 7and negative in 11.No significant difference in the incidence of SIRS was found between patients with positive urine culture and patients with negative urine culture（P〉0.05）.The sensitivity of urine culture for the detection of SIRS was 38.8%.Conclusion Under the condition of application of antibiotics,preoperative midstream urine culture was not correlated with postoperative SIRS in lithotripsy under flexible ureteroscope.Therefore,midstream urine culture is a poor predictor of postoperative SIRS.