Endoskopik üriner sistem taş tedavisi sonrası ürosepsis: riski artıran faktörler

Yıl 2021, Cilt: 13 Sayı: 1, 10 - 16, 31.01.2021

Dilek Bulut Merve Sefa Sayar Ender Cem Bulut Alper Bitkin Fatih Bıçaklıoğlu Serhat Çetin Murat Koparal Kasım Ertaş

Öz

Amaç: Üriner sistem taşları sıklığı giderek artan, sağlık sistemi üzerine ciddi mali yük oluşturan bir hastalıktır. Ürolitiyazisin endoskopik tedavisi sonrasında üriner enfeksiyonlar azımsanmayacak düzeydedir. Bu çalışmada endoskopik taş tedavisi alan hastalarda ürosepsis görülme insidansı ve bunu arttıran faktörleri inceledik. Böylece hastalarda ürosepsisi engellemeye yönelik alınacak tedbirlerle ilgili tartışamaya katkı sağlamayı amaçladık.

Gereç ve Yöntemler: Böbrek veya üreter taşı nedeni ile endoskopik taş tedavisi yapılan hastalar çalışmaya dahil edildi. Sepsis geçiren ve geçirmeyen olarak ayrılan iki grup birbiri ile yaş, cinsiyet, komorbidite, rezidü taş açısından birbiri ile kıyaslandı.

Bulgular: Çalışmaya dahil edilen toplam hasta sayısı 561’di. Çalışmaya dahil edilen hastaların median yaşı 39 (18-77)’ti. 18-40, 41-60 ve 61-80 yaş aralıklarına göre gruplanan hastalarda sırasıyla 12 (%4.2), 31 (%14.2) ve 9 (%16.7) hastada sepsis bulguları görüldü. Bu gruplar arasında sepsis görülme oranları açısından anlamlı fark vardı (p<0,001). Komorbiditesi olan hasta grubunda 39 (%25.3) hastada sepsis görülürken, komorbiditesi olmayan hasta grubunda 13 (%3.2) hastada sepsis görüldü. İki grup arasında sepsis görülme oranları açısından istatistiksel olarak anlamlı fark bulundu (p<0,001).

Sonuç: Postoperatif ürosepsisi kolaylaştırıcı etmenlerin bilinmesi, etkili proflaksi ve tedavide etkin antibiyoterapi açısından önemlidir. Yüksek hasta sayıları ile elde edilecek bulgular ürosepsisin yarattığı maliyet ve morbidite oranlarını düşürebilir.

Anahtar Kelimeler

ürosepsis, endoüroloji, antibiyotik, ürolitiyazis

Urosepsis after endoscopic urinary system stone treatment: factors increasing risk

Öz

Objective: Urinary system stones are an increasingly common disease that creates serious financial burden on the health system. Urinary infections are substantial after endoscopic treatment of urolithiasis. In this study, we examined the incidence of urosepsis in patients applied endoscopic stone treatment and the factors that increase it. Thus, we aimed to contribute to the discussion on measures to be taken to prevent urosepsis in patients.

Material and Methods: Patients who underwent endoscopic stone treatment for kidney or ureteral stones were included in the study. The two groups, which were divided into those with and without sepsis, were compared with each other in terms of age, gender, comorbidity, and residual stones.

Results: The total number of patients included in the study was 561. The median age of the patients included in the study was 39 (18-77). Sepsis findings were observed in 12 (4.2%), 31 (14.2%) and 9 (16.7%) patients, respectively, in patients grouped according to the age range of 18-40, 41-60 and 61-80 years. There was a significant difference between these groups in terms of the incidence of sepsis (p <0.001). While 39 (25.3%) patients had sepsis in the patient group with comorbidity, 13 (3.2%) patients had sepsis in the patient group without comorbidity. A statistically significant difference was found between the two groups in terms of the rates of sepsis (p <0.001).

Conclusion: Recognizing the factors that facilitate postoperative urosepsis is important for effective prophylaxis and effective antibiotherapy in treatment. Findings to be obtained with high patient numbers may decrease the cost and morbidity rates created by urosepsis.

Anahtar Kelimeler

urosepsis, endourology, antibiotic, urolithiasis

Kaynakça

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