Mogući faktori rizika od nastanka postoperativne urinarne infekcije nakon ureteroskopske litotripsije

  • Mirko D Jovanović Military Medical Academy, Urology Clinic
  • Vladimir Bančević Military Medical Academy, Urology Clinic
  • Branko Košević Military Medical Academy, Urology Clinic
  • Predrag Aleksić Military Medical Academy, Urology Clinic
  • Vesna Šuljagić Military Medical Academy, Department for Prevention and Control of Nosocomial Infection
DOI: https://doi.org/10.2298/VSP181014199J
Ključne reči: ureteroskopija;, litotripsija;, faktori rizika;, infekcija;, postoperativne komplikacije

Sažetak


Uvod/Cilj. Ureteroskopska litotripsija je u današnje vreme sigurna metoda endoskopskog razbijanja kamena u bubregu i ureteru, sa malim brojem komplikacija, od kojih je najčešća postoperativna urinarna infekcija.  Faktori rizika od pojave urinarne infekcije nakon ureteroskopskog razbijanja kamena u ureteru i bubregu nisu jasno rizika od njenog nastanka u našoj studiji su u skladu sa rezultatima studija drugih autora. Bolesnici koji boluju od definisani u dosadašnjim radovima. Metode. Istraživanjem je bilo obuhvaćeno 389 bolesnika kod kojih je urađena ureteroskopska litotripsija, a od mogućih faktora rizika analizirani su: starost bolesnika, pol, dijabetes, prisustvo i stepen hidronefroze, veličina kamena, lokalizacija kamena, nošenje ureteralne JJ sonde i perkutanog nefrostomskog katetera, vrsta operativne metode i dužina trajanja operacije. Statistički je bila analizirana učestalost postoperativne urinarne infekcije u odnosu na pomenute moguće faktore rizika. Rezultati. Postoperativnu urinarnu infekciju je imalo 10% bolesnika Veća učestalost postoperativne urinarne infekcije nađena je kod bolesnika koji su imali dijabetes (χ2 = 22,918; p < 0,001), koji su preoperativno nosili ureteralnu JJ sondu (χ2 = 4,620; p = 0,040) i perkutani nefrostomski kateter (χ2 = 8,240; p = 0,004), koji su imali veći kamen (Z = -3,301; p = 0,001) i kod kojih je operacija trajala duže (t = 4,261; p < 0,001). Zaključak. Učestalost postoperativne urinarne infekcije i faktori dijabetesa, koji preoperativno imaju postavljenu JJ sondu ili perkutani nefrostomski kateter, koji imaju veliki kamen i kod kojih je operativno vreme duže, imaju veći rizik od razvoja postoperativne urinarne infekcije. U skladu sa tim, značaj identifikacije ovih bolesnika u pripremi za ureteroskopsku litotripsiju doprinosi da se preduzme adekvatna preoperativna priprema i učestalost postoperativne urinarne infekcije smanji na najmanju meru.

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Objavljeno
2020/12/08
Broj časopisa
Vol. 77 Br. 11 (2020): Vojnosanitetski pregled
Rubrika
Originalni članak