Analysis Of Risk Factors Of Combined Flexible Ureteroscope Lithotripsy Complicated With Urosepsis

Objective:To investigate the related risk factors of urosepsis after combined flexible ureteroscope lithotripsy for providing clinical basis for the prevention,early diagnosis and early treatment of urosepsis.Method:The study inclued 406 patients with upper urinary calculi treated with combined flexible ureteroscope lithotripsy in the department of urology at the second hospital of Jilin university from January 2017 to October 2020.Thirty-two patients with postoperative urosepsis were selected as the urosepsis group,and 374 patients without urosepsis during the same period were selected as the control group.The clinical data of the two groups were compared and analyzed.The statistically significant risk factors were further analyzed by unconditional binary multivariate logistic regression analysis to screen out the independent risk factors of postoperative urosepsis.Result:1.Univariate analysis results:All the factors included in this study were analyzed by univariate analysis.In the data comparison between the two groups,the results showed that the differences were statistically significant(P<0.05).The factors included gender,diabetes,and preoperative infection symptoms,surgery history,stone location,stone diameter,cast stone,affected side stone obstruction,average stone CT value,WBC count in urine routine,urine nitrite,urine culture,WBC,operation time.2.Multivariate regression analysis results:After single factor analysis and screening of the various factors in this study,the results showed that the risk factors with statistical significance were further subjected to unconditional binary multivariate logistic regression analysis.The analysis results showed that 5 factors were independent risk factors for combined flexible ureteroscope lithotripsy complicated with urosepsis,and the difference was statistically significant(P<0.05).The 5 independent risk factors included gender,preoperative infection symptoms,affected side stone obstruction,operation time and positive urine culture.Conclusion:The results of this study showed that gender,preoperative symptoms of infection,stone obstruction on the affected side,operation time,and positive urine culture were independent risk factors for combined flexible ureteroscopy lithotripsy with urosepsis.Urosepsis is a rare complication of FURL,which often leads to delays in diagnosis and treatment,even endanger peoples lifes due to the lack of typical clinical manifestations in the early stage and the rapid progress of the disease.The results suggest that patients with these risk factors before surgery should be paid attention to,and the changes in relevant indicators and vital signs of patients should be closely monitored after surgery,in order to prevent the occurrence of postoperative urosepsis through early intervention,and early detection of urosepsis,to carry out relevant treatment as soon as possible to reduce the patient’s pain and reduce the patient’s economic burden.