CAJ | 학술논문

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1h。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。
목적：분석연성수뇨관신경격광쇄석도치술후농독패혈증성휴극급다기관공능쇠갈（MOF）적원인급예방。방법총결아원2013년6-7월빈채용연성수뇨관신경격광쇄석술치료신장결석21례，분석엄중수술병발증적발생원인。결과17례환자성공치유차일주내출원，4례환자술후5 h내발생농독패혈증성휴극，기중유2례진전위다기관공능쇠갈（MOF），1례창구무효사망。회고성분석소유병례，발현소유4례발생농독혈증성휴극적환자술전뇨배양균위양성，3례결석교대（＞2 cm），1례다발결석，쇄석시간균초과1h。결론술전뇨배양양성，결석대혹다발결석도치쇄석시간장（＞1 h）시연성수뇨관신경격광쇄석술후발생농독혈증성휴극적주요원인。
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 ureteroscope. 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 ureteroscope 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.