经皮肾镜碎石取石术后尿源性脓毒血症休克的防治

J4 ›› 2015, Vol. 14 ›› Issue (10): 28-30.

经皮肾镜碎石取石术后尿源性脓毒血症休克的防治

（大理大学附属医院，云南大理671000）

收稿日期:2015-01-12 出版日期:2015-10-15 发布日期:2015-10-15
作者简介:张爱建，医师，主要从事泌尿外科临床研究.

Prevention of Uroseptic Shock after Percutaneous Nephrolithotomy

（Affiliated Hospital of Dali University, Dali, Yunnan 671000, China）

Received:2015-01-12 Online:2015-10-15 Published:2015-10-15

摘要/Abstract

摘要：

目的：总结探讨经皮肾镜碎石取石术（Percutaneous Nephrolithotomy，PCNL）并发尿源性脓毒血症休克的防治措施。方
法：回顾性分析2010年1月至2014年11月治疗的714例PCNL患者，其中9例术后并发尿源性脓毒血症患者的临床资料。9例
患者术后1~4 h内出现寒战、呼吸急促（呼吸>30次/min）、高热（体温>39.0 ℃），心率加快（120~160次/min），血压下降（<90/60
mmHg），血常规提示白细胞>20×109/L或<4×109/L，血小板<60×109/L。临床诊断为尿源性脓毒血症休克，给予抗感染、抗休克等
治疗。结果：早期由于认识及经验不足，3例患者因多器官功能衰竭死亡。在总结早期经验的基础上，加强围手术期预防并早
期及时治疗，后期6例患者治愈出院。结论：PCNL术后尿源性脓毒血症休克起病急、发展迅速，加强围手术期的预防，早期诊
断并及时治疗，能有效降低术后尿源性脓毒血症休克的发生率及病死率。

关键词: 经皮肾镜碎石取石术, 尿源性脓毒血症休克, 防治措施

Abstract:

Objective: To summerize and explore the prevention of uroseptic shock after percutaneous nephrolithotomy. Methods:
Clinical data of 714 PCNL patients from January 2010 to November 2014 were retrospectively analyzed, among them, 9 were with
uroseptic after percutaneous nephrolithotomy. All 9 patients were characterized by chills, a breathing over 30 BPM, a temperature over
39.0 ℃, a heart rate from 120 to 160 BPM and a blood pressure below 90/60 mmHg within 1-4 hours after operation. They were
diagnosed with uroseptic shock by clinical manifestations and were treated by anti-infection and anti-shock therapies. Results: At
early stage, due to the lack of knowledge and experience, 3 patients died of multiple organ dysfunction failure. 6 patients were cured
with early diagnosis and rapid treatment after summarizing the cause of failure. Conclusion: Uroseptic shock can develop rapidly after
percutaneous nephrolithotomy. Effective prevention, early diagnosis and treatment can prevent uroseptic shock.

Key words: percutaneous nephrolithotomy, uroseptic shock, prevention

中图分类号:

R692.4

张爱建，郑宝寿，赵佳祥，肖芝松. 经皮肾镜碎石取石术后尿源性脓毒血症休克的防治[J]. J4, 2015, 14(10): 28-30.

Zhang Aijian, Zheng Baoshou, Zhao Jiaxiang, Xiao Zhisong. Prevention of Uroseptic Shock after Percutaneous Nephrolithotomy[J]. J4, 2015, 14(10): 28-30.

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