一例长期口服糖皮质激素患者在经皮肾镜碎石取石术后反复发热的管理经验

Management experiences of a patient with recurrent fever after percutaneous nephrolithotomy after long-term oral glucocorticoid

目的总结长期口服糖皮质激素患者在经皮肾镜碎石取石术后反复发热的管理过程,为长期口服糖皮质激素患者围手术期处理提供经验。方法回顾性分析贵州省人民医院收治的1例长期口服糖皮质激素患者在经皮肾碎石取石术后反复发热的临床资料,复习相关文献并予以讨论。结果患者经皮肾镜碎石取石术后出现反复高热,排除感染难治的各种风险因素后,考虑长期服用糖皮质激素引起自身免疫功能缺陷所致。在合理给予抗菌药物治疗,增强免疫力后患者好转出院。结论对于经皮肾镜碎石取石术后反复发热的患者,有必要排查有无引起自身免疫功能缺陷的因素,在合理使用抗菌药治疗的同时,减少免疫抑制因素,同时增强机体主动免疫和被动免疫。

Objective To summarize the management experiences of recurrent fever after percutaneous nephrolithotomy in patients with long-term oral glucocorticoids.Methods The data of one patient admitted to Guizhou Provincial People’s Hospital with recurrent fever after percutaneous nephro-lithotripsy with long-term oral glucocorticoids was retrospectively analyzed,then the relevant literature were reviewed and discussed.Results The patient developed recurrent hyperthermia after percutaneous nephrolithotomy,after excluding various risk factors for refractory infection,the patient was considered to have autoimmune deficiency caused by long-term oral glucocorticoid,and was discharged after reasonable antibacterial medication treatment and immunity enhancement.Conclusions Patients with recurrent fever after percutaneous nephrolithotomy,it is important to investigate whether there are factors that cause autoimmune deficiency,then reduce immunosuppressive factors and enhance the body's active and passive immune capacity while treating with reasonable antibacterial drugs.