Wagenlehner Florian M E, Weidner Wolfgang, Naber Kurt G
Urologic Clinic, Justus-Liebig-University Giessen, Germany.
Int J Antimicrob Agents. 2007 Nov;30(5):390-7. doi: 10.1016/j.ijantimicag.2007.06.027. Epub 2007 Aug 28.
Urosepsis in adults comprises approximately 25% of all sepsis cases and in most cases is due to complicated urinary tract infections (UTIs). In this paper we review the optimal management of urosepsis from the urological point of view. Urosepsis is often due to obstructed uropathy of the upper or lower urinary tract. The treatment of urosepsis comprises four major aspects: 1. Early goal-directed therapy; 2. Optimal pharmacodynamic exposure to antimicrobials both in blood and in the urinary tract; 3. Control of complicating factors in the urinary tract; 4. Specific sepsis therapy. Early tissue oxygenation, appropriate initial antibiotic therapy and rapid identification and control of the septic focus in the urinary tract are critical steps in the successful management of a patient with severe urosepsis. To achieve this goal an optimal interdisciplinary approach encompassing the emergency unit, urological specialties and intensive-care medicine is necessary.
成人泌尿系统脓毒症约占所有脓毒症病例的25%，在大多数情况下是由复杂性尿路感染（UTI）引起的。在本文中，我们从泌尿外科的角度综述了泌尿系统脓毒症的最佳治疗方法。泌尿系统脓毒症通常是由上尿路或下尿路梗阻性疾病引起的。泌尿系统脓毒症的治疗包括四个主要方面：1. 早期目标导向治疗；2. 在血液和尿路中实现抗菌药物的最佳药效学暴露；3. 控制尿路中的并发因素；4. 特异性脓毒症治疗。早期组织氧合、适当的初始抗生素治疗以及快速识别和控制尿路中的感染源是成功治疗严重泌尿系统脓毒症患者的关键步骤。为实现这一目标，需要一种涵盖急诊科、泌尿外科专业和重症医学的最佳跨学科方法。
