【摘要】 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1.5~2.5cm.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。更多还原

【Abstract】 Objective:To investigate prevention measures of urine-induced sepsis after flexible ureteroscope holmium laser lithotripsy in order to reduce the incidence.Methods:The clinical data of 5cases of urine-induced sepsis after flexible ureteroscope holmium laser lithotripsy were retrospectively analyzed.Two patients were diagnosed as having pyelolith,and three having calyceal calculus.Stone size was ranged from 1.5-2.5cm.Blood routine test,hepatorenal function,chest radiography,electrocardiogram before operation were normal.Urinalysis of three patients was normal,and leukocyte count of urinalysis was 5-12/Hp in two patients.Urine culture before operation was negative in 4patients.The first urine culture was positive for Escherichia coli in one patient,and re-examination of urine culture was negative after sensitive antibiotic administration.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.Sufficient 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 ureteroscope holmium laser lithotripsy.更多还原