Clinical Application Of Ureteroscopy In Urinary Calculi And Perioperative Infection Prevention

Objective:Clinical data of patients with upper urinary tract calculi treated with ureteroscopy combined with holmium laser,the results of group contrast ureteroscopy and postoperative infection complications.To evaluate the indications of flexible ureteroscopy in the treatment of urinary calculi,to analyze the main factors related to the treatment effect and perioperative infection,to improve the operative effect of soft mirror lithotripsy,and to reduce the possibility of postoperative infection.Methods: 433 cases of upper urinary tract calculi were treated with Ho:YAG laser lithotriptor through flexible ureteroscope.For statistical analysis of data using SPSS17.0software,P<0.05 that the difference was statistically significant.The basic characteristics of patients such as age,gender,previous surgery,basic diseases,kidney stones,basic characteristics of anatomy and operation time as group related risk factors were analyzed,the factors of the difference was statistically significant by univariate logistic regression analysis,followed by multivariate logistic regression analysis,to calculate the ratio of Odds(OR)and 95% confidence intervals(95%CI),with residual stones clearly lead to flexible ureteroscopy with holmium laser lithotripsy and the risk factors of postoperative infection.Results:In the retrospective study,the stone clearance rate after ureteroscopic lithotripsy was 84.38%.In the multivariate logistic regression analysis,the stone size(OR=1.82,95%CI:1.11-3.08),calyceal stones(OR=2.06,95%CI:1.39-7.34),multiple stones(OR=1.04,95%CI:5.66-13.28),intraoperative see signs of infection(OR=2.52,95%CI:0.21-0.52),the preliminary determination of risk factors for affecting ureter Holium laser lithotripsy and stone clearance rate.Flexible ureteroscopy postoperative fever in the study group(38.5 degrees)in 16 cases,fever rate was3.73%(16/429),logistic regression analysis,the size of the stones(OR=1.55,95%CI:1.99-2.47),lower calyceal calculi(OR=1.21,95%CI:0.19-0.81),renal pelvis funnel angle?30°(OR=0.28,95%CI:2.84-6.93),operation time(OR=3.89,95%CI:1.74-8.39),diabetes mellitus(OR=1.61,95%CI:1.52-1.86),intraoperative see signs of infection(OR=2.56,95%CI:0.21-0.56),which is the independent risk factors of postoperative fever of soft lens.Conclusion:We found that larger diameter stones,lower calyx calculi,multiple stones and signs of infection during operation were initially identified as risk factors for stone clearance after flexible ureteroscopy combined with holmium laser lithotripsy.In addition,the fever with a variety of factors for flexible ureteroscopy,stones,the larger diameter of the lower calyx calculi and IPA ? 30 °,the operation time and intraoperative signs of infection is an important risk factor.