上尿路腔镜碎石术后全身炎性反应综合征的原因分析和防治方法探讨  

Analysis of cause and management of systemic inflammatory response syndrome after endoscopic lithotripsy for upper urinary tract stones

作　　者：李凯[1] 钟明[1] 唐顺利[1] 黄顺坛[1] 袁明生[2] 甘群娣[3] 

机构地区：[1]广东医学院附属中山陈星海医院泌尿外科,广东中山528415 [2]广东医学院附属中山陈星海医院检验科,广东中山528415 [3]广东医学院附属中山陈星海医院手术室,广东中山528415

出　　处：《中国内镜杂志》2010年第6期625-628,共4页China Journal of Endoscopy

摘　　要：目的探讨输尿管镜碎石术(URL)和经皮肾镜微造瘘碎石术(MPCNL)术后出现全身炎性反应综合征(SIRS)的原因和有效防治措施。方法采用回顾性分析165例首次行上尿路碎石术病人的临床资料,将无SIRS组与SIRS组在灌注压、通道数、手术时间等方面进行比较、分析。结果 165例患者中发生SIRS共46例,共占27.88%。术中冲水压力和手术时间无SIRS组与SIRS组进行比较,差异有显著性(P<0.05)。结论术中灌注压过高、灌注液流出受阻、灌注液量过多、手术时间长等因素均可能引起SIRS。根据情况控制灌注压、灌注液量、控制手术时间、围手术期应用有效抗生素等可以降低和预防SIRS发生率。[Objective]To investigate the cause and effective management and prevention of systemic inflammatory response syndrome （SIRS） after endoscopic lithotripsy for upper urinary tract stones.[Methods]The clinical data of 165 patients after first endoscopic lithotripsy for upper urinary tract stones were retrospectively analyzed, and the irrigating pressure, numbers of tract and operation time were compared. [Results]46 cases of patients occurred SIRS （27.88% ）. The group with high-pressure irrigation and long-times operation had statistically higher incidence of SIRS than the others （P 0.05）.[Conclusions]The high-pressure irrigation , outflow tract obstruction of irrigating fluid, too much irrigating fluid, long-time of operation would result in SIRS. Elimination of these factors and application of antibiotics around the operation would reduce and prevent the SIRS.

关 键 词：上尿路结石 腔内碎石 全身炎性反应综合征 

分 类 号：R691.4[医药卫生—泌尿科学]