经皮肾镜碎石术-急性肺水肿、重症感染-多器官功能衰竭  

Percutaneous nephrolithotomy-acute pulmonary edema combined with severe sepsis-multiple organ failure

作　　者：李凤仙[1] 徐世元[1] 曾繁荣[1] 

机构地区：[1]南方医科大学珠江医院麻醉科,广州510282

出　　处：《国际麻醉学与复苏杂志》2011年第5期639-640,I0001,共3页International Journal of Anesthesiology and Resuscitation

摘　　要：经皮肾镜碎石术（percutaneous nephrolithotomy，PCNL）是尿石症的现代先进、微创治疗方法之一，在临床上应用广泛，但手术过程中可出现多种相关并发症。现报道1例ASAI级的女性患者，在手术即将结束时出现了顽固性低氧血症，继而出现休克、急性呼吸窘迫综合征、弥散性血管内凝血直至全身多器官功能衰竭，为PCNL术中同时合并了急性肺水肿及重症感染所致，提示在该类手术中应密切注意不寻常的咳嗽、寒战及低氧血症等表现，防止脓毒血症及急性肺水肿的发生。Percutaneous nephrolithotomy （PCNL） is one of the modern and microinvasive method to cure Urinary calculus. There are some complications during this process. We reported a case of severe hypoxia during PCNL under epidural block. The woman who coughed and chilled just after the procedure, then headed to acute pulmonary edema and severe sepsis, which brought her to shock then disseminated intravascular coagulation and multiple organ disufficiency syndron. The case gave us a lesson that we should take more attention while patients presented abnormal cough, shilling and hypoxemia, which indicated a severe condition of PCNL, a stepwise measure should be taken to prevent severe sepsis and lung edema.

关 键 词：经皮肾镜碎石术 重症感染 急性呼吸窘迫综合征 肺水肿 

分 类 号：R614[医药卫生—麻醉学]