[Valuable experiences and analysis of causes of urine-induced sepsis].

ABSTRACT

OBJECTIVE: To explore the characteristics, early symptoms and valuable experiences in the diagnosis and treatment of urine-induced sepsis. METHODS: The clinical data of 30 cases of urine-induced sepsis between August 2008 and April 2012 were reviewed retrospectively. Among them, YAG laser lithotripsy (n = 3) and transurethral prostatic resection (TURP) (n = 2) were performed. One case was after transurethral resection of bladder (TURB). There were 3 cases after cystectomy and Bricker and another 18 during and after percutaneous nephrolithotomy (PCNL). RESULTS: A total of 12 PCNL cases have significant drop in blood pressure during operation with non-bleed causes. A total of 26 cases developed symptoms of chills and high fever after 2 hours of surgery. The earliest symptoms of urine-induced sepsis were decline in blood pressure and high fever. After resistance to infection and symptomatic treatment actively, 27 patients were rescued successful (90%), 3 patients died (10%). Among the 3 deceased patients, 1 case was after YAG laser lithotripsy under ureteroscope, 1 case was after PCNL, 1 case was after TURP. CONCLUSIONS: The onset of urine-induced sepsis onset may be insidious. But this condition deteriorates rapidly and it is rather difficult to reverse. Most cases could be managed when the onset characteristics were recognized early. Prevention and early treatment are keys of lowering the mortality.