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华西医学  2011 

经皮肾镜碎石术后并发感染性休克的诊治

, PP. 1348-1350

Keywords: 微创经皮肾镜,感染性休克,上尿路结石

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Abstract:

【】 目的 探讨微创经皮肾镜碎石术后并发感染性休克的原因和防治措施。 方法 回顾性分析2005年1月-2010年12月5例经皮肾镜术300例,其中术后并发感染性休克5例的临床资料。男1例,女4例,均表现为术后2~8h内出现寒战、高热、烦燥不安,血压降至80/50mmHg(1mmHg=0.133kPa)以下,心率超过120次/min。所有患者均行抗感染和抗休克治疗。 结果 所有患者均在72h内停用升压药,1周内体温及血常规恢复正常,术后15d治愈出院。 结论 感染性休克是微创经皮肾镜碎石术严重的并发症之一,术前有效抗感染、术中低压灌注、术后加强生命体征的监测、早期发现并合理处理,可有效防治感染性休克的发生。【Abstract】 Objective Toexploretheetiologyandtreatmentofsepticshockafterpercutaneousnephrolithotomy. Methods FromJanurary2005toDecember2010,theclinicaldataoffivepatientswithsepticshockafterpercutaneousnephrolithotomyinourhospitalwereretrospectivelyanalyzed.Thepatients,includingonemaleandfourfemales,hadchillnessandhightemperatureafterthenephrolithotomy.Thebloodpressuredecreasedtounder80/50mmHg(1mmHg=0.133kPa),andtheheartratewasmorethan120perminute.Allpatientsunderwentanti-shockandanti-infectiontherapiesrapidly. Results Fivepatientswerecuredintheend,theirtemperatureandbloodroutinetestsreturnedtonormalwithinoneweek. Conclusions Septicshockisoneoftheseriouscomplicationsafterpercutaneousnephrolithotomy.Effectivepreoperativepreparation,lowpressureirrigationduringoperation,earlydiagnosisandtreatmentpostoperativelyaretheeffectivewaystopreventthesepticshock.

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