Early diagnosis and treatment of urinary sepsis after ureteroscopic lithotripsy of upper urinary tract stones

doi:10.3969/j.issn.1006-7795.2024.05.019

Abstract

Abstract: Objective To investigate the early diagnosis and treatment strategies for urinary sepsis after ureteroscopic lithotripsy for upper urinary tract stones.Methods A retrospective analysis was conducted on the data of 32 patients with upper urinary tract stones who developed urinary sepsis after ureteroscopic lithotripsy in Beijing Longfu Hospital from January 2019 to August 2023. Using a control principle and a 1∶2 ratio, clinical data of 64 patients who underwent surgery during the same period without urinary sepsis were selected for statistical analysis, and the risk factors and early diagnosis and treatment strategies for urinary sepsis were analyzed.Results By detecting blood white blood cells and procalcitonin at 2, 6, and 12 hours after surgery as key indicators for early warning, urinary sepsis was diagnosed early. Early treatment was given intravenous meropenem (1.0 once every 8 hours) as anti infective therapy, and fluid resuscitation therapy was performed to maintain the balance of inflow and outflow. All 32 patients with urinary sepsis recovered successfully. Univariate analysis suggests that age (≥ 60 years), surgery time (≥ 120 min), female gender, positive preoperative urine culture, preoperative fever, and stone diameter (≥ 20 mm) are independent risk factors for postoperative urinary sepsis in upper urinary tract stones (P<0.05). Conclusions Post ureteroscopic lithotripsy for upper urinary tract stones is associated with urinary sepsis, which is a clinical emergency and critical condition. Preoperative high-risk factors include age ≥ 60 years, female gender, positive urine culture before surgery, preoperative fever, and stone diameter ≥ 20 mm. Blood white blood cells and procalcitonin at 2, 6, and 12 h after surgery can be key indicators for early warning. Early detection and active anti infection treatment after surgery are key measures for the diagnosis and treatment of urinary sepsis.

Key words: upper urinary tract stones, ureteroscope, urinary sepsis, risk factors, early diagnosis and treatment

CLC Number:

Zhang Dakun, Zhang Hongbo, Dong Dexin, Gao Xiang, Zheng Han, Zhang Lang. Early diagnosis and treatment of urinary sepsis after ureteroscopic lithotripsy of upper urinary tract stones[J]. Journal of Capital Medical University, 2024, 45(5): 870-874.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2024.05.019

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2024/V45/I5/870

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