[1]齐桓,罗超,刘成山.体外冲击波碎石致尿脓毒症的临床分析[J].南方医科大学学报,2012,(10):1523.
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体外冲击波碎石致尿脓毒症的临床分析()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2012年10期
页码:
1523
栏目:
出版日期:
2012-10-01

文章信息/Info

Title:
Treatment of urosepsis induced by extracorporeal shock wave lithotripsy: analysis of 4 cases
作者:
齐桓罗超刘成山
关键词:
体外冲击波碎石脓毒症感染
Keywords:
extracorporeal shock wave lithotripsy urosepsis infection
摘要:
目的提高体外冲击波碎石(ESWL)术后并发尿脓毒症的临床认识及诊疗水平。方法对经ESWL后并发尿脓毒症的4例
患者的临床资料进行回顾性分析。4例肾结石或输尿管结石患者在接受ESWL术后6~36h内出现尿脓毒症的临床表现,尿细菌
培养2例为大肠埃希菌感染,1例肺炎克雷伯杆菌,1例大肠埃希菌并恶臭假单胞菌。结果4例患者经心电、血压及氧饱和度监
测,吸氧、补液、抗炎、升压等治疗,分别在术后5~11d(平均6.75d)生命体征恢复平稳,3例行输尿管镜下气压弹道碎石,1例紧急
行膀胱镜下DJ管置入引流肾盂液体,经保守治疗11d后结石排出,4例病人均痊愈出院。结论ESWL术前伴有泌尿系感染的
患者更易发生尿脓毒症;临床发现尿脓毒症时需要及早诊断,积极治疗,以保守治疗为主。
Abstract:
ObjectiveTo evaluate the strategy for management of urosepsis after extracorporeal shock wave lithotripsy (ESWL).
MethodsThe clinical data were analyzed in4cases of urosepsis caused by ESWL during the period from January,2008to
October2011. ResultsTwo of the patients had kidney stones and two had ureteral stones. Analysis of urine bacterial culture
revealed the presence of E. coli in2cases,Klebsiella pneumoniaein 1case andPseudomonas putidacombinedE. coliin 1case. All
the 4 patients were monitored for ECG, blood pressure and oxygen saturation, and received fluid replacement and
anti-inflammatory therapy. The vital signs of the patients became stable after5-11days (mean6.75days). Three patients
underwent ureteroscopic lithotripsy, and1patient had emergency ureteral stent indwelling. All the4patients were cured and
discharged.ConclusionsESWL is more likely to cause urosepsis in patients with ureteral stones and urinary infection, for
which early nonsurgical interventions should be administered immediately after the diagnosis is established.

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更新日期/Last Update: 1900-01-01