The Risk Factors Assessment For Endoscopic Treatment Of Kidney, Ureter Stones Postoperative Systemic Inflammatory Response Syndrome

[Objective]Both percutaneous nephrolithotomy.and holmium laser lithotripsy for urinary calculi ureteroscopy are the important methods of endovascular treatment of upper urinary tract calculi. The main complications include bleeding and infection which gradually attract the attention of urologists. Systemic inflammatory response syndrome (SIRS) is a common complication after Lithotripsy. In severe cases, urine-derived sepsis and septic shock would always happen. Antibiotic treatment of them is generally poor. If they were not detected early and treated quickly,they could become into multiple organ failure which would be severe life-threatening. Therefore, we should pay attention to the reasons for infection after URL and PCNL. To investigate the percutaneous nephrolithotomy, the holmium laser lithotripsy for urinary calculi ureteroscopy in patients with postoperative systemic inflammatory response syndrome (SIRS) is a risk factor for early, effective prevention and treatment of urinary tract stones endoscopic holmium laser gravel postoperative systemic inflammatory response syndrome (SIRS) provide a theoretical basis. [Methods] A retrospective analysis of clinical data June 2012-July 2014 in our department percutaneous nephrolithotomy, Holmium laser lithotripsy of 220 cases of patients, including the patient's gender, age, underlying diseases (high blood pressure, diabetes), stone size, location,operative time, intraoperative flushing fluid pressure, urine white blood cells and bacterial cultures, white blood cell, C-reactive protein and other indicators to assess the systemic inflammatory response syndrome risk factors by Logistic regression analysis. These cases were divided into SIRS group and non--SIRS group depending on whether having postoperative systemic inflammatory response syndrome, SIRS group 38 cases, non-SIRS group 182 cases, male patients 118 cases, female 102 cases,16 to 79 years old,126 cases with kidney stones,94 cases with ureteral stones.[Results]38 cases of patients with SIRS performance,17.3% of the cases, Including three cases of patients with septic shock,1.4% of the cases, which accepted Holmium laser lithotripsy ureteroscopy. The main clinical manifestations are high fever soon after operation, rapid decline in blood pressure, rapid increasing in heart rate, and rapid progression. The patients were diagnosed with urinary-derived sepsis and septic shock. They were transferred to the intensive care unit, and recovered after aggressive anti-infective, anti-shock, symptomatic and supportive treatment, no deaths. After univariate analysis, stone size, operative time, intraoperative flushing fluid pressure, urine white blood cells, C-reactive protein and other indicators may be considered postoperative endoscopic holmium laser lithotripsy the risk factor of SIRS.The difference was statistically significant (P<0.05).[Conclusions]SIRS is common postoperative complication after the upper urinary tract calculi with holmium laser lithotripsy. Diabetes, stone size, operative time, intraoperative fluid pressure, urine white blood cells, C-reactive protein are common factors affecting the emergence of SIRS,, which Urologist should pay adequate attention to. A variety of factors make patients after endoscopic holmium laser lithotripsy may appear SIRS, shorter operative time, low perfusion, infection control and acute response to preoperative possibility of postoperative SIRS can be reduced.