输尿管下段结石致尿脓毒血症1例及文献复习  

Treatment of Urosepsis Caused by Lower Ureteral Calculi: A Case Report

作　　者：刘桂勇[1] 张秉虎 何安仁 杜建兵[1] 万齐福 宋洪飞[1] 

机构地区：[1]湖北省潜江市中心医院泌尿外科,湖北潜江433100 [2]湖北省潜江市中心血站,湖北潜江433100

出　　处：《武汉大学学报（医学版）》2012年第4期603-605,共3页Medical Journal of Wuhan University

摘　　要：目的:结合1例输尿管下段结石致尿脓毒血症患者的抢救经过,探讨梗阻性尿脓毒血症的救治流程。方法:报告1例输尿管下段结石致尿脓毒血症女性患者,经抗休克、急诊肾造瘘引流处理,随之生命体征改善后再加强抗感染治疗,持续引流3月,肾功能改善,一般情况好转后Ⅱ期行钬激光碎石去除梗阻,成功抢救并治愈。结合文献对梗阻性尿脓毒血症救治进行复习。结果:抗休克及肾穿刺造瘘后待生命体征稍稳定后加强抗感染,Ⅱ期钬激光碎石等治疗后治愈。结论:结石梗阻性尿脓毒血症需早期诊断积极救治,有效的抗感染须建立在早期抗休克及充分引流基础之上,引流数周肾功能好转、全身状态改善后再手术去除梗阻是安全有效的处理流程。Objective： To evaluate the treatment of urosepsis by reporting a uroseptic case of lower ureteral calculi.Methods： A female uroseptic patient due to lower ureteral calculi was reported here.The processes of anti-shock and percutaneous nephrostomy were performed immediately,and anti-infection treatment followed when the vital sign was stable.Three months later,holmium laser lithotrity was performed and the calculi were removed.Results： Anti-infection treatment after the vital sign was stable was proved to be an effective method of the treatment of urosepsis,while the ureteral calculi was cured by holmium laser lithotrity later.Conclusion： Urosepsis should be treated immediately,and anti-infection treatment should be performed after the control of shock.Lithotrity is a safe therapy for uroseptic patients when shock and renal function were controlled.

关 键 词：尿脓毒血症 休克 治疗 结石 

分 类 号：R691.3[医药卫生—泌尿科学]