CAJ | 학술논문

目的总结经皮肾镜碎石(PCNL)术中冲洗液外渗并发多脏器功能障碍综合征(MODS)的诊断及治疗方法.方法报道本院2例患者PCNL术后发生MODS诊治经过.例1术中肾盂黏膜穿孔大量冲洗液外渗,术后继发MODS,经切开引流、输蛋白利尿等方法处理后好转.例2因术中冲洗液外渗,出血性休克继发MODS,经DSA栓塞、连续性肾脏替代治疗(CRRT)、抗感染治疗后好转.结果 2例患者MODS均控制,重要脏器功能基本恢复.结论术中干预可以防止PCNL术中冲洗液外渗MODS的发生,术后早期采取综合治疗措施可以促进重要脏器恢复.
목적 총결경피신경쇄석(PCNL)술중충세액외삼병발다장기공능장애종합정(MODS)적진단급치료방법.방법 보도본원2례환자PCNL술후발생MODS진치경과.례1술중신우점막천공대량충세액외삼,술후계발MODS,경절개인류、수단백이뇨등방법처리후호전.례2인술중충세액외삼,출혈성휴극계발MODS,경DSA전새、련속성신장체대치료(CRRT)、항감염치료후호전.결과 2례환자MODS균공제,중요장기공능기본회복.결론 술중간예가이방지PCNL술중충세액외삼MODS적발생,술후조기채취종합치료조시가이촉진중요장기회복.
Objectives To discuss the diagnosis and management of Multiple organ dysfunction syndrome MODS after the percutaneous nephrolithotomy(PCNL).Methods TWO cases with MODS after PCNL were reviewed.Case 1 was a man patient with staghorn calculi.After PCNL massive extravasation of irrigant fluid caused severe metabolic acidosis,and then it worsened to MODS,By sufficient drainage and using relative drugs the patient recovery quickly.Case 2 was a women patient.A massive haemorrage occurred after the PCNL.And acute hemorrhagic shock and severe sepsis happened,which brought her to MODS.Using DSA thrombosis of renal artery and continu-ous renal replacement therapy,the woman also recovered from the disease.Results The secondary MODS after PCNL was well controlled and nobody died.Conclusions The two cases gave us a lesson that we should take more attention while patients presented relative symptom.Then,the efficient intervention can be implemented.