上尿路结石相关性尿脓毒血症的诊疗研究进展
Advances in the Diagnosis and Treatment of Upper Urinary Tract Stone-Associated Urosepsis
DOI: 10.12677/acm.2025.152432, PDF,    科研立项经费支持
作者: 唐纳贤, 张唯力*, 任正举:重庆医科大学附属第二医院泌尿外科,重庆
关键词: 上尿路结石尿脓毒血症发病机制诊断方法治疗策略Upper Urinary Tract Stones Urosepsis Pathogenesis Diagnostic Methods Therapeutic Strategies
摘要: 上尿路结石相关性尿脓毒血症是一种危及生命的泌尿系统急症,尤以老年患者及伴有基础疾病者为高危人群。近年来,随着结石处理技术的进步,其发生率和预后有所变化。本文系统综述了该疾病的发病机制、诊断方法及治疗策略,强调早期诊断和及时干预的重要性,并探讨不同治疗手段对患者结局的影响。在现有研究的基础上,提出优化治疗方案的建议,以期为临床诊疗提供理论依据与实践指导。
Abstract: Upper urinary tract stone-associated urosepsis is a life-threatening urological emergency, particularly prevalent among elderly patients and those with underlying comorbidities. In recent years, advancements in stone management techniques have led to changes in its incidence and prognosis. This review systematically summarizes the pathogenesis, diagnostic methods, and therapeutic strategies of this condition, emphasizing the importance of early diagnosis and timely intervention. Furthermore, it explores the impact of various treatment modalities on patient outcomes. Based on existing studies, recommendations are proposed to optimize treatment protocols, aiming to provide theoretical support and practical guidance for clinical practice.
文章引用:唐纳贤, 张唯力, 任正举. 上尿路结石相关性尿脓毒血症的诊疗研究进展[J]. 临床医学进展, 2025, 15(2): 961-967. https://doi.org/10.12677/acm.2025.152432

参考文献

[1] Hesse, A., Brändle, E., Wilbert, D., Köhrmann, K.U. and Alken, P. (2003) Study on the Prevalence and Incidence of Urolithiasis in Germany Comparing the Years 1979 vs. 2000. European Urology, 44, 709-713. [Google Scholar] [CrossRef] [PubMed]
[2] Brikowski, T.H., Lotan, Y. and Pearle, M.S. (2008) Climate-Related Increase in the Prevalence of Urolithiasis in the United States. Proceedings of the National Academy of Sciences of the United States of America, 105, 9841-9846. [Google Scholar] [CrossRef] [PubMed]
[3] Romero, V., Akpinar, H. and Assimos, D.G. (2010) Kidney Stones: A Global Picture of Prevalence, Incidence, and Associated Risk Factors. Reviews in Urology, 12, e86-e96.
[4] Scales, C.D., Smith, A.C., Hanley, J.M. and Saigal, C.S. (2012) Prevalence of Kidney Stones in the United States. European Urology, 62, 160-165. [Google Scholar] [CrossRef] [PubMed]
[5] Cecconi, M., Evans, L., Levy, M. and Rhodes, A. (2018) Sepsis and Septic Shock. The Lancet, 392, 75-87. [Google Scholar] [CrossRef] [PubMed]
[6] Singer, M., Deutschman, C.S., Seymour, C.W., Shankar-Hari, M., Annane, D., Bauer, M., et al. (2016) The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 315, 801-810. [Google Scholar] [CrossRef] [PubMed]
[7] Zheng, R., Zhang, Y., Rong, Z., Huang, W. and Fu, X. (2021) [Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021, Interpretation and Expectation]. Chinese Critical Care Medicine, 33, 1159-1164.
[8] Oczkowski, S., Alshamsi, F., Belley-Cote, E., Centofanti, J.E., Hylander Møller, M., Nunnaly, M.E., et al. (2022) Surviving Sepsis Campaign Guidelines 2021: Highlights for the Practicing Clinician. Polish Archives of Internal Medicine, 132, Article 16290. [Google Scholar] [CrossRef] [PubMed]
[9] Dreger, N.M., Degener, S., Ahmad-Nejad, P., Wöbker, G. and Roth, S. (2015) Urosepsis—Etiology, Diagnosis, and Treatment. Deutsches Ärzteblatt international, 112, 837-847. [Google Scholar] [CrossRef] [PubMed]
[10] Bhojani, N., Miller, L.E., Bhattacharyya, S., Cutone, B. and Chew, B.H. (2021) Risk Factors for Urosepsis after Ureteroscopy for Stone Disease: A Systematic Review with Meta-analysis. Journal of Endourology, 35, 991-1000. [Google Scholar] [CrossRef] [PubMed]
[11] Blackmur, J.P., Maitra, N.U., Marri, R.R., Housami, F., Malki, M. and McIlhenny, C. (2016) Analysis of Factors’ Association with Risk of Postoperative Urosepsis in Patients Undergoing Ureteroscopy for Treatment of Stone Disease. Journal of Endourology, 30, 963-969. [Google Scholar] [CrossRef] [PubMed]
[12] Kreydin, E.I. and Eisner, B.H. (2013) Risk Factors for Sepsis after Percutaneous Renal Stone Surgery. Nature Reviews Urology, 10, 598-605. [Google Scholar] [CrossRef] [PubMed]
[13] Cao, J.D., Wang, Z.C., Wang, Y.L., Li, H.C., Gu, C.M., Bai, Z.G., et al. (2022) Risk Factors for Progression of Urolith Associated with Obstructive Urosepsis to Severe Sepsis or Septic Shock. BMC Urology, 22, Article No. 46. [Google Scholar] [CrossRef] [PubMed]
[14] Wagenlehner, F.M., Lichtenstern, C., Rolfes, C., Mayer, K., Uhle, F., Weidner, W., et al. (2013) Diagnosis and Management for Urosepsis. International Journal of Urology, 20, 963-970. [Google Scholar] [CrossRef] [PubMed]
[15] Hong, X., Liu, G., Chi, Z., Yang, T. and Zhang, Y. (2023) Predictive Model for Urosepsis in Patients with Upper Urinary Tract Calculi Based on Ultrasonography and Urinalysis Using Artificial Intelligence Learning. International braz j urol, 49, 221-232. [Google Scholar] [CrossRef] [PubMed]
[16] Chugh, S., Pietropaolo, A., Montanari, E., Sarica, K. and Somani, B.K. (2020) Predictors of Urinary Infections and Urosepsis after Ureteroscopy for Stone Disease: A Systematic Review from EAU Section of Urolithiasis (EULIS). Current Urology Reports, 21, Article No. 16. [Google Scholar] [CrossRef] [PubMed]
[17] Petrosillo, N., Granata, G., Boyle, B., Doyle, M.M., Pinchera, B. and Taglietti, F. (2019) Preventing Sepsis Development in Complicated Urinary Tract Infections. Expert Review of Anti-Infective Therapy, 18, 47-61. [Google Scholar] [CrossRef] [PubMed]
[18] Wagenlehner, F.M.E., Weidner, W. and Naber, K.G. (2007) Optimal Management of Urosepsis from the Urological Perspective. International Journal of Antimicrobial Agents, 30, 390-397. [Google Scholar] [CrossRef] [PubMed]
[19] Nishiguchi, S., Branch, J., Suganami, Y., Kitagawa, I. and Tokuda, Y. (2014) Effectiveness of Early Ureteric Stenting for Urosepsis Associated with Urinary Tract Calculi. Internal Medicine, 53, 2205-2210. [Google Scholar] [CrossRef] [PubMed]
[20] Bakr, M. and Abdelhalim, K.M. (2020) Safety and Efficacy of Emergency Ureteroscopy with Intracorporeal Lithotripsy in Patients Presented with Urinary Tract Infection with Mild Sepsis. Journal of Endourology, 34, 262-266. [Google Scholar] [CrossRef] [PubMed]
[21] Wollin, D.A., Joyce, A.D., Gupta, M., Wong, M.Y.C., Laguna, P., Gravas, S., et al. (2017) Antibiotic Use and the Prevention and Management of Infectious Complications in Stone Disease. World Journal of Urology, 35, 1369-1379. [Google Scholar] [CrossRef] [PubMed]
[22] Mancuso, G., Midiri, A., Gerace, E., Marra, M., Zummo, S. and Biondo, C. (2023) Urinary Tract Infections: The Current Scenario and Future Prospects. Pathogens, 12, Article 623. [Google Scholar] [CrossRef] [PubMed]
[23] Ripa, F., Massella, V., Ong, A., Mani Sinha, M., Pietropaolo, A. and Somani, B. (2023) Role of Ureteroscopy (URS) and Stone Treatment in Patients with Recurrent UTIs: Outcomes over a 10-Year Period. Journal of Clinical Medicine, 12, Article 3591. [Google Scholar] [CrossRef] [PubMed]
[24] Wang, L., Yu, X., Qiu, Z., Liu, P., Tian, W., He, W., et al. (2024) Influence of Preoperative Urine Culture and Bacterial Species on Urogenital Sepsis after Ureteral Flexible Lithotripsy in Patients with Upper Urinary Tract Stones. Frontiers in Medicine, 11, Article 1393734. [Google Scholar] [CrossRef] [PubMed]