[摘要] 目的 探讨经尿道输尿管软镜钬激光碎石术后并发尿源性脓毒血症的高危因素及相关防治策略。方法回顾性分析2018年1月至2022年12月于广元市中心医院泌尿外科行输尿管软镜钬激光碎石术的641例患者，收集其术后发生不同程度尿源性脓毒血症的42例患者的临床数据并进行分析。结果 术后并发尿源性脓毒血症的比例为6.55%(42/641)，患者经术后检测2h和12h的血常规及降钙素原指标、心电监护监测生命体征及医护早期观察识别等，及时预测和发现脓毒血症的征兆，通过积极早期使用强效抗生素抗感染、抗休克等综合治疗后，均获得痊愈。结论分析显示女性、高龄、体质差及合并糖尿病、免疫系统疾病(长期服用激素)、心肺功能不全等基础疾病者及术前尿培养(+)可能是术后并发脓毒血症的高危因素。因此术前合理的个体化治疗方案及认真的术前准备，术中娴熟而精细的操作、合理控制注水压、掌控好手术时间，术后早期识别并及时有效的干预至关重要。

    [关键词] 输尿管软镜；脓毒血症；高危因素；预防；治疗

    [中图分类号] R691.3 [文献标识码] A [DOI] 10.3969/j.issn.1673-9701.2024.27.017

    Todiscusstheriskfactors and prevention of urosepsis after flexible ureteroscopic holmium laser lithotripsy

    Department of Urology， GuangyuanCentral Hospital，Guangyuan 628000，Sichuan， China

    [Abstract]ObjectiveTo explore the high-risk factors and related prevention and treatment strategies of urosepsis after transurethral flexible ureteroscopic holmium laser lithotripsy. MethodsA retrospective analysis was conducted on 641 patients who underwent flexible ureteroscopic holmium laser lithotripsy in the Department of Urology， GuangyuanCentral Hospitalfrom January 2018 to December 2022. The clinical data of 42 patients with different degrees of urosepsis after surgery were collected and analyzed. ResultsThe proportion of postoperative complications of urogenic sepsis was 6.55% (42/641). Patients underwent postoperative blood routine tests at 2h and 12h ......