摘要
目的:探讨影响泌尿外科腔镜手术后尿源性脓毒血症的预后因素,改善尿源性脓毒血症的预后。方法:回顾性分析57例泌尿外科腔镜手术后尿源性脓毒血症的患者资料,并按照严重程度分为低危组和高危组,比较按照临床资料特征、化验结果的区别。结果:在57例脓毒血症患者中,高危组24例,低危组33例,在性别构成(男/女)、术前尿路感染方面,高危组明显高于低危组,两组间差异有统计学意义。在手术方式方面,高危组患者中输尿管镜手术比例明显高于低危级,而经皮肾镜比例明显低于低危组,两组间差异有统计学意义。手术时间方面,高危组明显长于低危组,两组间差异有统计学意义。术后血白细胞、中性粒细胞、C反应蛋白、多脏器功能障碍发生率、血培养阳性率方面,高危组高于低危组,而术后至出现脓毒血症症状时间间隔(手术-感染时间)、血小板、血红蛋白、纤维蛋白原方面低于低危组,两组间差异有统计学意义。结论:男性、术前存在尿路感染、合并糖尿病、输尿管镜手术、手术时间过长是尿源性脓毒血症预后不良的因素;术后血中性粒细胞比例明显升高、C反应蛋白升高、发生多脏器功能障碍、血培养阳性、手术-感染时间短、血小板下降、血红蛋白下降、纤维蛋白原降低是预后不良的指标。
Objective： To investigate the prognostic factors of urosepsis after surgery with urologic endoscopy and to improve the prognosis ofurosepsis. Methods： A retrospective analysis of clinical data of 57 patients was carried who occurred urosepsis after surgery with urologic endoscopy. These cases were divided into low-risk group and high risk group and compared the difference of clinical data and laboratory results. Results： Of 57 cases of urosepsis, 24 patients were divided into high-risk group and 33 cases into low risk group. There were significant differences in the ratio of male/female, urinary tract infection and diabetes mellitus between high-risk group and the low-risk group. In terms of operation, ureter surgery in high-risk group was higher than low risk level, but percutaneous nephrolithotripsy was significantly lower than the low-risk group, and surgical time of high- risk group was significantly longer than that of low-risk group. Postoperative blood leukocytes, neutrophils,C-reactive protein, multiple organ dysfunction, blood culture positive ratio in the high-risk group is higher than the low-risk group, and the time interval from surgery to uroseptic symptoms occurring （interval time of surgery-infection）, fibrinogen, platelets, hemoglobin in high risk group were lower than low risk group. Conclusion： Male, urinary tract infection, diabetes mellitus, ureteroscopy and longer surgical time are the factors of poor prognosis of urosepsis; significantly higher blood neutrophils after surgery, elevated c-reactive protein, multiple organ dysfunction, positive blood culture, shorter interval time of surgical-infection and lower platelets, lower hemoglobin, lower fibrinogen are the poor prognostic indicators
出处
《临床与病理杂志》
CAS
2015年第4期587-592,共6页
Journal of Clinical and Pathological Research
