国际麻醉学与复苏杂志   2019, Issue (9): 0-0
    
Sepsis 3.0在上尿路腔内碎石术后脓毒症诊断中的应用
崔晓环, 吴安石1()
1.首都医科大学附属北京儿童医院
Diagnostic efficacy of Sepsis 3.0 for urosepsis after ureteroscopic procedures of the upper urinary tract
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摘要:

目的  验证Sepsis 3.0中序贯器官衰竭评分(sequential organ failure assessment, SOFA)对尿源性脓毒症的诊断意义。 方法 择期行上尿路腔内碎石术患者540例,根据术后是否发生脓毒症分为脓毒症组(17例)与非脓毒症组(523例),收集患者性别、年龄、MAP、氧合指数、格拉斯哥昏迷评分、总胆红素、血小板计数、血Cr等资料,根据Sepsis 3.0分别进行术前及术后SOFA评分。 结果 临床判断17例患者术后发生脓毒症,发生率为3.15%。两组患者术后SOFA评分、术后与术前SOFA评分的差值(ΔSOFA)差异有统计学意义(P<0.01),ΔSOFA阳性预测值最高,且阳性似然比更接近于0。 结论 在尿源性脓毒症的诊断中,ΔSOFA最具临床意义。

关键词: 上尿路腔内碎石术; 尿源性脓毒症; Sepsis 3.0; 序贯器官衰竭评分
Abstract:

Objective To verify the diagnostic efficacy of the sequential organ failure assessment (SOFA) score in Sepsis 3.0 for urosepsis. Methods A total of 540 patients undergoing ureteroscopic procedures of the upper urinary tract in our hospital were enrolled in the study. They were divided into two groups as sepsis group and non-sepsis group based on whether patients developed to sepsis or not. The data such as gender, age, mean arterial pressure (MAP), oxygenation index, Glasgow Coma Score, total bilirubin, platelet, serum creatinine were recorded. Results Sepsis occurred in 17 patients, and the incidence was 3.15%. The monofactor analysis shows that the difference between the two groups in postoperative SOFA score, ΔSOFA (the difference between postoperative SOFA score and the preoperative SOFA score) were statistically significant (P<0.01). ΔSOFA has higher positive predictive value and lower positive likelihood ratio. Conclusions The ΔSOFA has clinically significance in the diagnosis of urosepsis.

Key words: Ureteroscopic procedures of the upper urinary tract; Urosepsis; Sepsis 3.0; Sequential organ failure assessment