微创泌尿外科杂志
微創泌尿外科雜誌
미창비뇨외과잡지
Journal of Minimally Invasive Urology
2015年
4期
221-223
,共3页
毛俊彪%袁平成%桂定文%彭伟%陈小刚%张青汉
毛俊彪%袁平成%桂定文%彭偉%陳小剛%張青漢
모준표%원평성%계정문%팽위%진소강%장청한
输尿管软镜%钬激光%尿源性脓毒血症%肾结石
輸尿管軟鏡%鈥激光%尿源性膿毒血癥%腎結石
수뇨관연경%화격광%뇨원성농독혈증%신결석
flexible ureteroscope%Holmium laser%Urine-induced sepsis%kidney stone
目的::探讨输尿管软镜钬激光碎石术后尿源性脓毒血症的预防措施,以降低发生率.方法:回顾性分析输尿管软镜钬激光碎石术后出现尿源性脓毒血症5例患者的临床资料:2例诊断为肾盂结石,3例诊断为肾盏结石.结石大小1.5~2.5 cm.术前血常规、肝肾功能、胸片、心电图等均正常,尿常规检查3例正常,2例白细胞5~12个/Hp,术前尿培养4例为阴性,1例患者第一次尿培养为大肠埃希菌,给予敏感抗生素治疗后复查尿培养阴性.患者均在全麻下行输尿管软镜钬激光碎石术.结果:5例患者术后出现不同程度尿脓毒血症,经选用敏感抗生素,并对症支持治疗,患者均痊愈出院.结论:尿源性脓毒血症是输尿管软镜钬激光碎石术后严重的并发症之一.术前充分准备,术中控制手术时间,术后严密监测,以及尽早选用敏感抗生素是防治输尿管软镜钬激光碎石术后尿源性脓毒血的关键.
目的::探討輸尿管軟鏡鈥激光碎石術後尿源性膿毒血癥的預防措施,以降低髮生率.方法:迴顧性分析輸尿管軟鏡鈥激光碎石術後齣現尿源性膿毒血癥5例患者的臨床資料:2例診斷為腎盂結石,3例診斷為腎盞結石.結石大小1.5~2.5 cm.術前血常規、肝腎功能、胸片、心電圖等均正常,尿常規檢查3例正常,2例白細胞5~12箇/Hp,術前尿培養4例為陰性,1例患者第一次尿培養為大腸埃希菌,給予敏感抗生素治療後複查尿培養陰性.患者均在全痳下行輸尿管軟鏡鈥激光碎石術.結果:5例患者術後齣現不同程度尿膿毒血癥,經選用敏感抗生素,併對癥支持治療,患者均痊愈齣院.結論:尿源性膿毒血癥是輸尿管軟鏡鈥激光碎石術後嚴重的併髮癥之一.術前充分準備,術中控製手術時間,術後嚴密鑑測,以及儘早選用敏感抗生素是防治輸尿管軟鏡鈥激光碎石術後尿源性膿毒血的關鍵.
목적::탐토수뇨관연경화격광쇄석술후뇨원성농독혈증적예방조시,이강저발생솔.방법:회고성분석수뇨관연경화격광쇄석술후출현뇨원성농독혈증5례환자적림상자료:2례진단위신우결석,3례진단위신잔결석.결석대소1.5~2.5 cm.술전혈상규、간신공능、흉편、심전도등균정상,뇨상규검사3례정상,2례백세포5~12개/Hp,술전뇨배양4례위음성,1례환자제일차뇨배양위대장애희균,급여민감항생소치료후복사뇨배양음성.환자균재전마하행수뇨관연경화격광쇄석술.결과:5례환자술후출현불동정도뇨농독혈증,경선용민감항생소,병대증지지치료,환자균전유출원.결론:뇨원성농독혈증시수뇨관연경화격광쇄석술후엄중적병발증지일.술전충분준비,술중공제수술시간,술후엄밀감측,이급진조선용민감항생소시방치수뇨관연경화격광쇄석술후뇨원성농독혈적관건.
Objective:To investigate prevention measures of urine-induced sepsis after flexible ureteroscope holmium la-ser lithotripsy in order to reduce the incidence.Methods:The clinical data of 5 cases of urine-induced sepsis after flexible ure-teroscope holmium laser lithotripsy were retrospectively analyzed.Two patients were diagnosed as having pyelolith,and three having calyceal calculus.Stone size was ranged from 1.5-2.5 cm.Blood routine test,hepatorenal function,chest radio-graphy,electrocardiogram before operation were normal.Urinalysis of three patients was normal,and leukocyte count of u-rinalysis was 5-12/Hp in two patients.Urine culture before operation was negative in 4 patients.The first urine culture was positive for Escherichia coli in one patient,and re-examination of urine culture was negative after sensitive antibiotic admin-istration.All patients were subjected to flexible ureteroscope holmium laser lithotripsy under general anesthesia.Results:Five patients had sepsis to varying degrees after operation and cured after sensitive antibiotic administration combined with symptomatic and supportive treatment.Conclusions:Urine-induced sepsis was one of the most serious complications.Suffi-cient preoperative preparation,control of operation time,postoperative monitoring closely and usage of sensitive antibiotic administration as soon as possiblewere key measures for preventing and treating urine-induced sepsis after flexible uretero-scope holmium laser lithotripsy.