目的：探讨严重尿脓毒血症患者的临床特点，为早期发现、及时诊治尿脓毒血症提供策略。方法回顾性分析我院2011年3月~2016年8月收治并确诊为严重尿脓毒血症患者的临床资料，分析尿脓毒血症发生原因并比较不同干预时机、不同治疗方案对患者预后的影响。结果共计32例严重尿脓毒血症患者纳入本项研究，其中男性8例，女性24例，平均年龄47岁。病因包括上尿路结石24例、肾脓肿2例、气肿性肾盂肾炎2例及肿瘤化疗术后继发复杂性尿路感染4例。24例上尿路结石患者中，20例患者术前明确诊断为严重尿脓毒血症而行外科引流，其中13例行患侧输尿管支架置入术，成功率为53.8%，7例直接行经皮肾穿刺造瘘术，成功率71.4%。结论尿脓毒症状仍是不容忽视的危重症，在临床工作中，既要及时有效并有效处理尿脓毒血症，又要求在围手术期警惕该危重症的发生。%Objective To evaluate clinical charateristics of severe urosepsis patients in a retrospetive analysis and to provide strategies for effective diagnosis and therapy of urosepsis. Methods We assessed retrospectively all patients who were diagnosed as severe urosepsis in our hospital between March 2011 and August 2016 . Results In 32 patients with severe urosepsis (24 women and 8 men; mean age 47 years) , Patient characteristics and therapeutic interventions were were evaluated. The pathological mechanism leading to severe urosepsis included 24 cases of upper urinary stone,2 cases of renal abscess,2 cases of emphysematous pyelonephritis, and 4 cases of complicated urinary infection secondary to chemotherapy for urological cancer. In 20 cases of upper urinary stone who were diagnosed as severe urosepsis pre-operatively, 13 patients recieved ureteric stent with a success rate of 53.8% and ultrasound-guided percutaneous nephrostomy were performed in 7 cases with a success rate of 71.4%. Conclusion Urosepsis is a life-threatening medical condition which requires enough emphasis in clinic.
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