输尿管镜钬激光碎石术后尿源性脓毒血症的诊治(附8例报告)  

Diagnosis and treatment of urosepsis after ureteroscopy with holmium laser lithotripsy

作　　者：王华礼[1] 孙旭东[1] 乔庆东[1] 郭静[1] 任胜杰[1] 

机构地区：[1]新乡市中心医院泌尿外科,河南新乡453000

出　　处：《河南医学研究》2017年第24期4438-4440,共3页Henan Medical Research

摘　　要：目的总结输尿管镜钬激光碎石术后尿源性脓毒血症的早期诊断治疗经验,为临床指导诊疗该类疾病提供参考依据。方法回顾性分析2016年1月至2017年1月新乡市中心医院收治的8例输尿管镜钬激光碎石术后尿源性脓毒血症患者的临床资料。结果 8例尿源性脓毒血症不同程度合并尿源性脓毒血症相关危险因素,中段尿细菌培养阴性4例,阳性4例:大肠埃希菌3例、铜绿假单胞菌1例。8例均能及时诊断尿源性脓毒血症,4例白细胞计数>12×109/L,4例白细胞计数<4×109/L,PCT<0.05~22.09 ng/m,2例进展为感染性休克,无死亡病例。结论相关危险因素的评估、预警指标的检测为脓毒血症抢救的早诊断提供指导,及时合理应用抗感染药物可提高脓毒血症抢救成功率。Objective To summarize the experience of early diagnosis and treatment of urinary sepsis after ureteroscopic holmium laser lithotripsy and provide reference for clinical guidance and treatment of such diseases. Methods The clinical data of eight patients with urinary sepsis after ureteroscopic holmium laser lithotripsy were retrospectively analyzed from January of 2016 to January of 2017 in Xinxiang Central Hospital. Results Eight cases of urinary sepsis with varying degrees of urinary sepsis associated risk factors, the middle of the urine culture negative in four cases, four were positive ： three cases of Escherichia coli, Pseudomonas aeruginosa in one case. Eight cases were diagnosed as urinary sepsis in time, four cases of leukocyte count more than 12×10^9/L, four cases of white blood cell count less than 4×10^9/L, PCT 〈 0.05 - 22.09 ng/m, two cases of progress Septic shock, no deaths. Conclusion The assessment of relevant risk factors and the detection of early warning indexes provide guidance for the early diagnosis of sepsis rescue. The timely and rational use of anti - infective drugs can improve the success rate of sepsis rescue.

关 键 词：输尿管镜钬激光碎石术 尿源性脓毒血症 诊断 治疗 

分 类 号：R691.3[医药卫生—泌尿科学]