输尿管镜碎石术后发热性尿路感染风险评估 研究进展

Research Progress on Risk Assessment of Febrile Urinary Tract Infection after Ureteroscopic Lithotripsy

摘要: 输尿管镜碎石术(URS)是治疗输尿管结石的主要微创方式，但术后发热性尿路感染(FUTI)仍较常见，且可能进展为严重并发症。因此，准确评估感染风险并实现早期识别，对改善预后具有重要意义。现有研究表明，FUTI的发生与多因素相关，包括微生物入侵、术中肾盂压力升高及宿主免疫反应等。炎症标志物可反映炎症状态，但预测能力有限，多用于辅助判断。CT等影像学检查在评估结石负荷、梗阻程度及炎症征象方面更具客观性。近年来，整合临床特征、炎症指标与影像学参数的多因素模型逐渐成为研究热点，并显示出更高的预测价值。未来仍需开展多中心前瞻性研究，以优化模型并精准评估感染风险与个体化管理。

Abstract: Ureteroscopic lithotripsy (URS) is a primary minimally invasive treatment for ureteral stones; however, postoperative febrile urinary tract infection (FUTI) remains relatively common and may progress to severe complications. Therefore, accurate assessment of infection risk and early identification are essential for improving patient outcomes. Current studies indicate that the occurrence of FUTI is multifactorial, involving microbial invasion, elevated intrarenal pressure during surgery, and host immune responses. Inflammatory biomarkers can reflect the inflammatory status, but their predictive value is limited and they are mainly used as adjunctive indicators. Imaging modalities, particularly computed tomography (CT), provide more objective evaluation of stone burden, degree of obstruction, and inflammatory signs. In recent years, multivariable models integrating clinical characteristics, inflammatory markers, and imaging parameters have become a research focus and have demonstrated improved predictive performance. Future multicenter prospective studies are still needed to optimize these models and enable precise risk assessment and individualized management of infection.