目的 评估可弯曲负压吸引鞘联合输尿管软镜治疗直径1~3 cm肾结石疗效,并探讨术后发生感染的危险因素。方法 选取2025年1—12月在本院接受可弯曲负压吸引鞘联合输尿管软镜碎石取石治疗的1~3 cm肾结石患者（100例）,记录并统计其临床资料,包括一般资料、结石特征、手术时间、一期结石清除率、住院时间及并发症发生情况等。根据术后是否发生感染并发症将患者分为感染组与非感染组,采用单因素及多因素logistic回归分析术后感染的危险因素。结果 100例患者均顺利完成手术,术中均未出现中转开放以及经皮手术情况,一期结石清除率为92.0%（92/100）,其中无石率为78.0%,残石≤4 mm者占14.0%。平均手术时间为（62.4±15.8） min,平均住院时间为（4.6±1.3） d。术后并发症发生率为13.0%（13/100）,以Clavien-DindoⅠ~Ⅱ级为主。术后7例（7.0%）发生感染相关并发症,主要表现为发热或尿路感染,经积极抗感染及对症处理后均好转,无严重脓毒症或死亡病例。多因素logistic回归分析结果表明,术前尿培养阳性、手术时间延长及结石负荷较大是术后感染的独立危险因素（P<0.05）。结论 对1~3 cm肾结石患者进行可弯曲负压吸引鞘联合输尿管软镜碎石取石治疗,效果较为显著,结石清除率较高且并发症较少。患者术后感染的发生与术前尿路感染状态、结石负荷及手术时间等因素有关;提示通过术前评估和感染控制以及优化手术操作流程均可进一步降低患者术后感染的发生风险,值得临床推广应用。

Objective To investigate the efficacy of flexible negative pressure suction sheath combined with ureteroscope in the treatment of 1-3 cm renal stones and the risk factors for postoperative infection. Methods The study enrolled 100 patients with 1-3 cm renal stones in our hospital from January to December 2025. All patients were treated by flexible negative pressure suction sheath combined with ureteroscope lithotripsy. General patient information, stone characteristics, operation time, primary stone clearance rate, hospital stay, and complications were recorded. Patients were divided into an infection group and a non-infection group based on whether postoperative infection complications occurred. Univariate and multiple logistic regression analyses were used to analyze the risk factors for postoperative infection. Results All 100 patients successfully completed the surgery without conversion to open surgery or percutaneous surgery. The primary stone clearance rate was 92.0% （92/100）, with a stone-free rate of 78.0% and residual stones ≤ 4 mm accounting for 14.0%. The average operation time was （62.4±15.8） min, and the average hospital stay was （4.6±1.3） d. The postoperative complication incidence rate was 13.0% （13/100）, mainly Clavien-Dindo grade I-II. Seven cases （7.0%） developed infection-related complications after surgery, mainly presenting as fever or urinary tract infection. All patients improved after aggressive anti-infection and symptomatic treatment, with no severe sepsis or deaths. Multiple logistic regression analysis indicated that preoperative positive urine culture, prolonged operation time, and large stone burden were independent risk factors for postoperative infection （P<0.05）. Conclusion Flexible negative pressure suction sheath combined with ureteroscope is effective in the treatment of patients with 1-3 cm renal stones, with a high stone clearance rate and few complications. The occurrence of postoperative infection in patients is related to factors such as preoperative urinary tract infection status, stone burden, and operation duration. Preoperative assessment, infection control, and optimization of surgical procedures can further reduce the risk of postoperative infection in the patients, and are worthy of clinical promotion and application.