上尿路腔内碎石术后并发尿脓毒血症的处理和预防

目的探讨上尿路腔内碎石术后并发尿脓毒血症的原因和防治措施。方法回顾性分析2006年7月～2009年7月上尿路腔内碎石术后4例尿脓毒血症患者的临床资料,根据临床表现均诊断为尿脓毒血症。6例均给予抗休克和抗感染等治疗。结果 4例患者在10～48h后逐渐停用升压药物,1周内体温和血常规恢复正常,最后治愈出院。1例因出现多脏器功能障碍综合征(MODS)而于术后第6天抢救无效死亡。结论尿脓毒血症是上尿路腔内碎石术后严重并发症之一,早期发现及合理处理是治疗成功的关键,加强预防措施可减少术后重症感染。

Objective To explore the etiology,management and prevention of urosepisis after endoscopic lithotripsy for upper urinary tract stones.Methods A clinical date was retrospective analyzed which collected 4 patients of urosepisis after endoscopic lithotripsy for upper urinary tract stones from Jul 2006 to Jul 2009.The diagnose of all the patients were urosepisis according to the clinical manifestation.All patients underwent ant-shock and ant-infection therapies rapidly.Results The hypertensors of 3 patients were gradually stopped within 10～48 hours,their temperature and blood routine tests returned to normal within 1 week.3 patients were cured in the end.1 patients was died of multiple organ dysfunction syndrome(MODS)after 6 days of operation.Conclusion Urosepisis is one of serious complications after endoscopic lithotripsy for upper urinary tract stones.The key to the successful treatment depend on early diagnosis and proper treatment.The improvement in the prevention can effective prevent the post-operation severe infection.