Abstract: 【Abstract】 Objective To investigate the correlation between preoperative urine and intraoperative stone culture in percutaneous nephrolithotomy （PCNL），and the role of intraoperative stone culture in systemic inflammatory response syndrome（SIRS）. Methods From July 2014 to July 2016，preoperative urine culture and intraoperative stone culture were obtained in 40 patients undergoing in PCNL. The postoperative SIRS events，antibiotics sensitivity and any changes in treatment. Results Of 40 cases， there were 13 cases（32.5%）with preoperative urine culture positive results and 27（67.5%）sterile，26 （65%）with intraoperative stone culture positive results and 14（35%）sterile. The positive rates of stone culture were higher than that of preoperative urine culture（P<0.05）. Sterile both preoperative and stone culture were found in 10 （25%） patients. Sterile stone culture and urine culture positive results were found in 4 （10%） patients. Sterile urine culture and stone culture positive results were found in 17 （42.5%）patients. urine culture and stone culture positive results were found in 9（22.5%）patients. In these cases，there was different types of bacteria. Otherwise SIRS happened in 10 patients. Conclusion Intraoperative stone culture can be more accurate to reflect the bacterial infection than preoperative urine culture.

Key words: calculi, bacterial culture, percutaneous nephrolithotomy, urine

摘要： 【摘要】目的 探讨经皮肾镜取石术（PCNL）术前中段尿培养和术中结石培养的关系以及术中结石培养在PCNL中预防全身炎症反应综合征（SIRS）的应用价值。方法 分析2014年7月~2016年7月40例PCNL患者术前中段尿培养和术中结石培养的结果，术后SIRS发生情况，药物的敏感性以及调整抗生素的情况。结果 本组40例患者中，术前中段尿培养有菌生长13例，占比32.5%，无菌生长27例，占比67.5%。术中结石细菌培养有菌生长26例，占比65%，无菌生长14例，占比35%。术中结石细菌培养阳性率显著高于术前中段尿培养（P<0.05）。术前中段尿和术中结石细菌培养均无细菌生长10例（25%），术前中段尿培养有菌生长而术中结石细菌培养无菌术中4例（10%），术前中段尿培养无菌生长而术中结石细菌培养有菌生长17例（42.5%），术前中段尿培养和术中结石细菌培养均有细菌生长9例（22.5%），其中9例中，有4例分别为不同的细菌。术后发生SIRS10例。结论 术中结石培养比术前中段尿培养更能反应尿路感染情况,对预防和治疗PCNL相关性感染有指导治疗作用。

关键词: 尿液, 结石, 细菌培养, 经皮肾镜取石术