Risk Factors Of Fever After The Operation Of Upper Urinary Lithiasis

Background and ObjectiveThe rapid development of endoscopic techniques makes the surgical department of Urology percutaneous nephrolithotomy and ureteroscopic lithotripsy become the first choice for the treatment of upper urinary calculi.The urology physicians also pay more attention to the postoperative complications. SIRS caused by infection is one of the common complications.Even if the preoperative use of antibiotics, the incidence is still25.8%-39.8%.Severe infections can lead to septic shock,and if not treated in time, it can develop into multiple organ failure, and endanger the life.In the clinical manifestations of SIRS, fever is one of the most important and most easy to find.So we think it is necessary to pay attention to the fever after operation, understand the causes and risk factors of fever,discussion on the measures of prevention and treatment.It will have important guiding significance for the prevention of SIRS.MethodsTo make a retrospective analysis of100cases who underwent the operation of upper urinary lithiasis from June2012to February2013. They are divided into2groups by whether have postoperative fever. We analyzed the factors such as age, sexuality, basic diseases, urinary tract infection before operation, stone situation, the degree of hydronephrosis, operative time,and so on.Then we compared the fever rate between each factors by the the statistical method and discussion on the measures of prevention and treatment.ResultsFever after the operation occurred in14cases. It was related to basic diseases, stone situation,preoperative urinary tract infection, operative time, intraoperative blood loss and so on. There was a significant difference between fever group and non-fever group (P<0.05). But the age, sexuality and the degree of hydronephrosis had no statistical significan(P>0.05)ce. Preoperative urinary tract infection, stone size, operative time, operative bleeding were statistically significant by multiple factors analysis of Logistic regression model (P<0.05). ConclusionFever after the operation of upper urinary lithiasis is more common, so these factors must be taken into account such as basic diseases, stone situation,preoperative urinary tract infection, operative situation,they may cause infection and fever easily. With reoperative urinary tract infection, big stone, long operative time and large bleeding volume, patients are more susceptible to have postoperative infection fever.Urinary tract infection is the major cause of fever after operation.So adequate preoperative and reasonable control of blood glucose, treatment for urinary tract infections, intraoperative skilled operation, using effective antibiotics and strengthen the nursing after the operation, can consider as measures to prevent postoperative fever.