To discuss the risk factors and prevention of urosepsis after flexible ureteroscopic holmium laser lithotripsy
10.3969/j.issn.1673-9701.2024.27.017
- VernacularTitle:输尿管软镜钬激光碎石术后并发脓毒血症的防治策略
- Author:
Zugang SUN
1
;
Zhong WANG
Author Information
1. 广元市中心医院泌尿外科,四川广元 628000
- Keywords:
l Flexible ureteroscope;
Urogenic sepsis;
High risk factors;
Prevention;
Treatment
- From:
China Modern Doctor
2024;62(27):75-78
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the high-risk factors and related prevention and treatment strategies of urosepsis after transurethral flexible ureteroscopic holmium laser lithotripsy.Methods A retrospective analysis was conducted on 641 patients who underwent flexible ureteroscopic holmium laser lithotripsy in the Department of Urology,Guangyuan Central Hospital from January 2018 to December 2022.The clinical data of 42 patients with different degrees of urosepsis after surgery were collected and analyzed.Results The proportion of postoperative complications of urogenic sepsis was 6.55％(42/641).Patients underwent postoperative blood routine tests at 2h and 12h,procalcitonin indicators,electrocardiographic monitoring of vital signs,and early observation and recognition by medical staff to predict and detect signs of sepsis in a timely manner.Through active early use of potent antibiotics to combat infection,shock,and other comprehensive treatments,all patients were cured.Conclusion Analysis show that women,advanced age,poor constitution,combined with diabetes,immune system diseases(long-term use of hormones),and underlying diseases such as cardiopulmonary insufficiency.Preoperative urine culture(+)may be a high-risk factor for postoperative sepsis.Therefore,reasonable individualized treatment plans and careful preoperative preparations before surgery,skilled and meticulous operations during surgery,reasonable control of water pressure,and good control of operation time,early identification after surgery and timely and effective intervention are extremely important.
