微创经皮肾镜碎石治疗肾铸状结石合并全身炎症反应综合征的临床护理

Clinical nursing of minimally invsive percutaneous nephrolithotomy lithotripsy in treatment for kidney stones and systemic inflammatory response syndrome

目的探讨微创经皮肾镜碎石(MPCNL)治疗肾铸状结石合并全身炎症反应(SIRS)的临床护理。方法共收集MPCNL术后合并SIRS 11例,其中男性5例,女性6例;年龄(42.5±12)岁。MPCNL术后11例患者均给予足量应用抗生素,强化微循环支持,保护内环境稳定,并给予积极的营养支持等措施。结果术后具有T>38℃,WBC>12×109/L两项者为3例;术后具有T>38℃,WBC>12×109/L,HR>90次/min 3项者为3例;术后具有T>38℃,WBC>12×109/L,R>20次/min或PaCO2<4.27 kPa 3项者1例;4项指标均异常者4例,其中出现感染性体克3例,这11例患者经对症治疗后,均顺利康复出院。结论 MPCNL治疗肾铸状结石合并SIRS的临床护理重点是严密监测生命体征,及时了解实验室相关指标的监测结果,加强管道护理,保持有效引流,防止病情恶化。

Objective To investigate clinical nursing of the minimally invasive percutaneous nephrolithotomy in treat- ment of kidney stones and systemic inflammatory response syndrome.Methods 11 cases with systemic inflammatory re- sponse syndrome,of which 5 males and 6 females,aged （42.5±12）years.Care for these patients were close monitoring of vital signs,to keep of relevant indicators for monitoring laboratory results,reinforce pipeline care,maintenance of effec- tive drainage and prevent disease progression.Results After the operation,there were 3 patients with T〉38~C,WBC〉12x lO~/L;3 patients with T〉38~C,WBC〉I2x109/L,HR〉90 times/rain;1 case with T〉38~C,WBC〉12xlOg/L,R〉20 times/min or PACO2〈4.27 kPa;4 cases hadall data abnormal and 3 patients with septicshock.The positive symptomatic treatment with the appropriate clinical care,the 11 patients were able to recover,no death.Conclusion Care for these systemic in- flammatory response syndrome patients were close monitoring of vital signs,to keep of relevant indicators for monitoring laboratory results,reinforce pipeline care,maintenance of effective drainage and prevent disease progression.