Analysis Of Risk Factors Related With SIRS After Flexible Ureteroscopy And Holmium Laser Lithotripsy

Objective:To analyze the main risk factors related wit h SIRS(systemic inflammatory response syndrome)after flexible ureteroscopy and Holmium laser lithotripsy,and to explore the prevention and treatment strategies,as to reduce the incidence of postoperative SIRS.Methods:The clinical data of 106 patients who underwent flexible ureteroscopy and Holmium laser lithotripsy successfully in the first urology department of our hospital from May 2015 to December 2016 were reviewed.All the patients' gender(male / female),age(< 60 years / ?60 years),body mass index(BMI)(<25kg/m2?25.00~29.99 kg/m2??30 kg/m2),complicated with hypertension(yes / no),complicated with diabetes(yes / no),treatment history of affected side urinary calculi(have / have not),recent fever history related with calculi(have / have not),complicated with renal insufficiency(yes / no),preoperative double-J tube drainage(yes / no),preoperative urinary infection(yes / no),preoperative urine culture(negative / positive),preoperative antibiotic application(prophylactic application / therapeutic application),flexible ureteroscopy type(combined type / digital type),subrenal calyx calculi(yes / no),the maximum diameter of calculi(<2cm/?2cm),operation time(<90min/?90min),struvite stones(yes / no)were input by the Excel2007.All factors were classified according to the presence of postoperative SIRS.Univariate analysis was first done by Pearson ? 2test through SPSS22.0.Multivariate Logistic regression analysis was carried out among those significant risk factors in univariate anayls is.P <0.05 is considered significant statistically.Results:All the 106 patients successfully underwent flexible ureteroscopy and Holmium laser lithotripsy,postoperative SIRS took place in 16 cases,the inc idence rate is 15.1%.In univariate analysis,complicated with renal insuffic iency(P=0.008),preoperative urine culture positive(P<0.001),subrenal calyx calculi(P=0.023),the maximum diameter of calculi ?2cm(P=0.041),the operation time?90min(P=0.003),struvite stones(P<0.001)were the main factors related with postoperative SIRS.In the multivariate Logistic regression analys is,preoperative urine culture positive(OR=4.702,95%CI: 1.063~20.801)(P=0.041),the operation time?90min(OR=10.854,95%CI: 1.199~98.282)(P=0.034)and struvite stones(OR=12.231,95%CI:,1.233~121.328)(P=0.032)were the independent risk factors that significantly increased the risk of postoperative SIRS.Conclusion:Preoperative urine culture positive,operation time?90min,struvite stones are the independent risk factors that can significantly increase the risk of postoperative SIRS after flexible ureteroscopy and Holmium laser lithotripsy.