Objective: To investigate the prognostic factors of urosepsis after surgery with urologic endoscopy and to improve the prognosis of urosepsis.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. hTere were signiifcant 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 ifbrinogen are the poor prognostic indicators.%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.
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