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| Clinical analysis of postoperative sepsis after flexible ureteroscope lithotripsy |
| ZHANG Zhihong1 JIN Shihua1 HUANG Huagang2 ZHOU Jianfang2 GUO Hongfeng1 JIN Lianchao1 WANG Gang1 LI Ningchen1 |
1.Peking University Shougang Hospital Peking University Wujieping Urology and Surgery Center, Peking 100144, China;
2.Department of Urology, Peking University Shougang Shuigang General Hospital, Guizhou Province, Liupanshui 553000, China |
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Abstract Objective To analyze the related factors, clinical diagnosis and treatment of postoperative sepsis after flexible ureteroscope lithotripsy and explore its prevention and treatment measures. Methods Clinical data of 25 patients with sepsis in 786 cases of ureteroscopic holmium laser lithotripsy in two urinary centers from November 2010 to December 2016 were retrospectively analyzed. Hospital stay, anti-infection treatment time, clinical outcome were observed. Preoperative conventional urine culture and drug sensitivity test were performed in all the patients. Double J tubes were indwelled for 7-10 days. Intraoperative intravenous antibiotics were routinely applied. OLYMPUS F3.6/9.9 flexible ureteroscope and Power Suite100W holmium laser were used for lithotripsy. Results 16 cases showed positive results of preoperative urine culture, the operation time was 55-175 min, an average of (94±11) min; hospital stay was 13-28 days, an average of (14.4±1.5) days; postoperative anti-infective treatment time was 3-10 days, the average of (4.1±1.5) days. 11 patients were with severe sepsis after surgery, 9 patients were with septic shock, of which 7 cases were refered to ICU. Conclusion Preoperative, intraoperative and postoperative control are critical for prevention and treatment of sepsis. Early detection of clinical signs and proper treatment is the key to the successful management of postoperative sepsis after flexible ureteroscope lithotripsy.
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