The Impact Of Urinary Bacteria On Percutaneous Nephrolithotomy Postoperative Septic Shock

Objective:To study the influence of urine bacteria to septic shock after percutaneous nephrolithotomy (PCNL).Material and Method:Review of urological minimally invasive department in Shandong provincial hospital from May2008to October2011admission of266treated with percutaneous nephrolithotomy patients for clinical material, all cases preoperatively took the middle urine bacteria cultures and the conventional antibiotic prophylaxis. Through the chi-square analysis the influence of urine culture and days of antibiotics prophylactic treatment to the septic shock of postoperative.Results:266cases of patients,9cases of the postoperatie septic shock (3.4%),midstream urine culture positive was79cases (29.7%), preoperative antibiotic use for preventive anti-inflammatory treatment≤3days was93cases (35%). With positive urine culture, gram-negative bacteria infection58cases (73.4%), gram-positive10cases (12.7%), the mixed bacteria group of11cases (13.9%). The chi-square analysis showed that the urine culture positive and antibiotics prophylaxis treatment≤3days are significantly related with septic shock(p<0.05), the odds ratio (OR) were5.041and6.959.Conclusion:Urine culture positive before the operation and use of antibiotics prophylaxis treatment within three days are the risk factors of septic shock,in the urinary tract bacterias gram-negative bacterium is the most main pathogenic bacteria group. Percutaneous nephrolithotomy preoperative midstream urine bacteria culture, according to antimicrobial susceptibility test results choose sensitive antibiotics preventative treatment>3days, to preventing postoperative septic shock is very necessary.