经皮肾镜碎石术并发急性肺水肿、脓毒性休克1例报告并文献复习  

Acute pulmonary edema and septic shock during percutaneous nephrolithotomy:a case report and review of literature

作　　者：陈瑞霞[1] 彭玉璇[1] 杜素娟[1] 叶西就[1] CHEN Ruixia;PENG Yuxuan;DU Sujuan;YE Xijiu(Department of Anesthesiology,Sun Yat-sen Memorial Hospital,Guangzhou,510289,China)

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,广州510289

出　　处：《岭南现代临床外科》2019年第2期203-206,210,共5页Lingnan Modern Clinics in Surgery

摘　　要：经皮肾镜碎石术(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。现报告1例ASAI级47岁女性患者因"双肾结石并泌尿系感染",在腰硬联合麻醉下行左侧经皮肾镜碎石术,术中出现低氧血症急性肺水肿,继而脓毒性休克,结合文献对经皮肾镜碎石术中并发急性肺水肿、脓毒性休克的防治进行复习,术中麻醉医生要加强对生命体征的监测,及时发现、及时处理出现的并发症,主动参与到围术期医学中,在并发症的防治中发挥重要作用,对病人的预后有重要的意义。Percutaneous nephrolithotomy(PCNL)is a modern and minimally invasive treatment for urinary calculi disease,but a variety of related complications can appear in the process of the surgery.Now we reported an ASA 47-year-old woman with calculi in both kidneys and urinary infection,she was scheduled for elective percutaneous nephrolithotomy under combined spinal-epidural anesthesia. During the operation,the patient developed the symptoms of hypoxia and acute pulmonary edema,and later sep-tic shock. After reviewing the literature,we explore the prevention and treatment of acute pulmonary ede-ma and septic shock that appear in PCNL,and anesthesiologists should be actively involved in the peri-operative medicine,play an important role in the prevention and cure of complications of PCNL,which is of great importance on the prognosis of patients.

关 键 词：经皮肾镜碎石术 急性肺水肿 感染性休克 文献复习 

分 类 号：R619.3[医药卫生—外科学]