软输尿管镜激光碎石致败血症休克原因分析  

Analysis of the causes of septic shock after laser lithotripsy for renal calculi through flexib leureteroscope

作　　者：邱涛[1,2] 李鸣[1,2] 唐矛[2] 

机构地区：[1]新疆医科大学,新疆乌鲁木齐830000 [2]新疆维吾尔自治区人民医院泌尿中心,新疆乌鲁木齐830001

出　　处：《中华腔镜外科杂志（电子版）》2014年第1期39-42,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的分析软性输尿管肾镜激光碎石导致术后脓毒败血症性休克及多器官功能衰竭(MOF)的原因及预防。方法总结我院2013年6-7月份采用软性输尿管肾镜激光碎石术治疗肾脏结石21例,分析严重手术并发症的发生原因。结果 17例患者成功治愈且一周内出院,4例患者术后5 h内发生脓毒败血症性休克,其中有2例进展为多器官功能衰竭(MOF),1例抢救无效死亡。回顾性分析所有病例,发现所有4例发生脓毒血症性休克的患者术前尿培养均为阳性,3例结石较大(>2 cm),1例多发结石,碎石时间均超过1 h。结论术前尿培养阳性,结石大或多发结石导致碎石时间长(>1 h)是软性输尿管肾镜激光碎石术后发生脓毒血症性休克的主要原因。Objective Analysis of the causes of septic shock and multiple organ failure （MOF）after laser lithotripsy for renal calculi through flexible ureteroscope. Methods Retrospective analysis of the severe complications laser lithotripsy through flexible ureteroscope for the treatment of renal calculi in our department from June to July in 2013. Results Total of 21 patients with renal calculi treated with laser lithotripsy through flexible ureteroseope. Of which 17 patients were successfully treated and discharged from hospital within one week. Sepsis and septic shock occured in 4 patients, 2 of them progressed into MOF and one died. All of 4 patients with sepsis septic shock after laser lithotripsy through flexible ureteroseope had positive urine culture preoperatively and 3 had large stone （ 〉 2 cm） and one had multi-calculi. Operation （lithotripsy） time was longer than 1 hour in all of the 4 patients. Conclusion Preoperative positive urine culture and large stones and long lithotripsy time were the major reasons of sepsis septic shock after laser lithotripsy through flexible ureteroscope.

关 键 词：软性输尿管肾镜 碎石 脓毒血症 败血症性休克 MOF 预防 

分 类 号：R459.7[医药卫生—急诊医学]