尿源性脓毒症的研究进展

Research advance in urosepsis

尿源性脓毒症是指由于泌尿系统或者男性生殖器官的感染引起的脓毒症。近年来随着腔镜泌尿外科的发展,尿源性脓毒症的发病率和相关死亡人数逐年上升。作为泌尿外科风险最大、预后最差的并发症之一,尿源性脓毒症病情进展迅速,如对其未能早期诊断并及时正确处理,易迅速进展为脓毒症休克,危及患者生命。因此,早期识别及正确诊治尿源性脓毒症对降低相关病死率和改善预后具有重要意义。尿源性脓毒症的治疗关键在于早期液体复苏、早期使用抗生素及控制和消除易感因素,其围手术期处理需要外科,ICU,感染科及麻醉科医生之间的多学科协作及共同管理。本文就尿源性脓毒症的诊断标准及流行病学、病因及发病机制、危险因素和围手术期处理等相关研究进展作一综述。

Urosepsis refers to sepsis induced by infection of the urinary tract and/or male reproductive system. Recently, with the development of endoscopic urology, the incidence of urosepsis and related deaths have been increasing year over year. As one of the most risky and poorest prognosis complications in urology, urosepsis progresses rapidly. If it is not diagnosed early and treated promptly, urosepsis is easy to develop into septic shock and pose a serious threat to patients’ life. Therefore, early identifi cation and correct diagnosis and treatment of urosepsis are of great signifi cance to reduce the mortality and improve the prognosis. The key to treat urosepsis is early fluid resuscitation, early antibiotic use, as well as control and elimination of susceptibility factors. Th e perioperative management of urosepsis requires the multidisciplinary collaboration of surgeons, ICU clinicians, infectious physicians, and anesthesiologists. This review summarizes the diagnostic criteria, epidemiology, etiology, pathogenesis, risk factors, and perioperative management of urosepsis.