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| Risk Factors of Urosepsis after Urinary Stone Surgery and Efficacy of Early Continuous Renal Replacement Therapy |
| GAO Peng, WANG Peng, WU Zhe |
| Emergency Department, Xi'an High-tech Hospital, Xi'an Shaanxi 710075, China |
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Abstract 【Objective】To investigate the risk factors of urosepsis after urinary stone surgery and discuss the efficacy of early continuous renal replacement therapy for postoperative urosepsis. 【Methods】Of 2752 patients with urinary stone surgery in the Department of Urology Surgery of our hospital,167 patients with urosepsis were in the urosepsis group, and the remaining 2585 patients without urosepsis were in the non-urosepsisl group. Multivariate Logistic regression analysis was used to screen the risk factors affecting urosepsis. Thereafter, patients in the urosepsis group were further divided into two subgroups according to different treatment methods:67 patients with early continuous renal replacement therapy were classified into the observation group and 100 patients without early continuous renal replacement therapy were set as control group. The changes of relevant serological indexes after treatment were compared between two groups. 【Results】The incidence of postoperative urosepsis in patients was correlated with the age, preoperative antibiotic use, blood routine test, urine routine test, urine culture, stone size, operation time and perfusion volume (P<0.05). Age ≥60 years, positive blood routine test, positive urine routine test, positive urine culture, stone size >2.0 cm, operation time >100 min and intraoperative perfusion volume >30 L were all risk factors for urosepsis after urinary stone surgery. At 48h after operation, levels in procalcitonin, C-reactive protein, white blood cell count and neutrophils ratio in the observation group was significantly lower than those in the control group (P<0.05). While the levels of hemoglobin, platelet count, fibrinogen and standards bicarbonate in observation group was also significantly higher than that in control group (P<0.05). 【Conclusion】Age ≥ 60 years old, blood routine test (+), urine routine test (+), urine culture (+), stone size >2.0 cm, operation time >100 min and perfusion volume > 30 L are independent risk factors for patients with urosepsis after urinary stone surgery. In this circumstance, early continuous renal replacement therapy can effectively improve the prognosis of patients with urosepsis after urinary stone surgery.
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Received: 12 May 2020
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2022, Vol. 39 
