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《经皮肾镜取石术后尿脓毒症休克2例报告并文献复习.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、现代医药卫生2014年6月30日第3O卷第12期JModMedHealth,June30,2014,Vo1.30,No.12·1791·短篇论著·经皮肾镜取石术后尿脓毒症休克2例报告并文献复习胡道荣,徐世田,李杰,温鹏,王延建(重庆市合川区/,-rE医院泌尿外科,重庆401520)【摘要】目的探讨行经皮肾镜取石术(PCNL)后尿脓毒症休克的防治。方法报告该科2013年1~12月收治的64例肾结石患者,术前给予3d抗感染治疗,并行大通道经皮肾镜气压弹道碎石术后其中2例患者出现尿脓毒症休克,结合文献对PCNL后出现尿脓
2、毒症休克的防治进行复习。结果1例患者术后20min开始出现血压下降、心率加快、高热,经补液、扩容、抗感染等综合治疗后治愈出院;1例患者手术碎石120min后突然出现寒战、心率加快、血压下降。立即终止手术后经抗休克、抗感染等治疗后治愈出院。结论术前给予患者充分抗感染治疗.术中灌洗保持低压.术后密切监测生命体征和神志变化并加强抗感染治疗,可有效防治PCNL后尿脓毒症休克的发生【关键词】碎石术;休克,脓毒性;尿路结石;手术后期间;经皮肾镜取石术;尿脓毒症休克doi:l0.3969~.issn.1009—5519.2014
3、.12.ol3文献标识码:A文章编号:1009—5519(2014)12.1791—02Urosepticshockviapercutaneousnephrolithotomy:2casesreportandreviewofliteratureHuDaorong,XuShitian,Li此,Wen昭,WangYanjian(DepartmentofUrology,ChongqingHechuanDistrictPeopleSHospital,Chongqing401520,China)【Abstract】Objec
4、tiveToexplorethepreventionandtreatmentofurosepticshockbypercutaneousnephrolithotomy(PCNL).MethodsSixty—fourpatientswithcalculiinthekidneysreceivedbythisdepartmentandacceptedanti—bioticstherapyforthreedays.Afteranpneumaticlithotripsyofmajorchannelvianephroscope
5、wasconductedandthentwoofthemwereinurosepticshock.ReviewingcombinedwithliteratureabouturosepticshockafterPCNL.ResultsTwentyminutesaftersurgeryonepatientdevelopedthesymptomssuchasurosepticshockwithbloodpressurefall,rapidheartrateandhyperpyrexia,whowaspromptlytre
6、atedwithfluidreplacement,dilatationandanti—infection,andeventuallydischargedaftertheabovecomprehensivetherapy.Anothersuddenlyhadchills.rapidheartrate,dropofbloodpressureafter120rainwhenfinishingthelithotripsy.Immedi—atelytheoperationwasstoppedinsteadofgivingan
7、ti—shockandanti—infection.ConclusionThecomprehensivetherapeuticscheduleofanti—infectiontreatmentbeforeoperation,keepingalowbloodpressurewithlavageduringtheoperation,aclosemoni—toringofvitalsignsandconsciousnesschangeaftertheoperationaswellasstrengtheninganti—i
8、nfectionshallpreventeffectivelyurosepticshockafterPCNL.【Keywords】Lithotripsy;Shock,septic;Urinarycalculi;Postoperativeperiod;Percutaneousnephrolithotomy;Urosepticshock肾结石是泌尿外科常见疾病,
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