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目的探讨微创经皮肾镜碎石术后并发感染性休克的原因和防治措施。方法回顾性分析2005年1月-2010年12月5例经皮肾镜术300例,其中术后并发感染性休克5例的临床资料。男1例,女4例,均表现为术后2~8 h内出现寒战、高热、烦燥不安,血压降至80/50 mm Hg(1 mm Hg=0.133 kPa)以下,心率超过120次/min。所有患者均行抗感染和抗休克治疗。结果所有患者均在72 h内停用升压药,1周内体温及血常规恢复正常,术后15 d治愈出院。结论感染性休克是微创经皮肾镜碎石术严重的并发症之一,术前有效抗感染、术中低压灌注、术后加强生命体征的监测、早期发现并合理处理,可有效防治感染性休克的发生。
Objective To investigate the causes and prevention and treatment of septic shock after minimally invasive percutaneous nephrolithotomy. Methods The clinical data of 5 cases of percutaneous nephroscopy from January 2005 to December 2010 were retrospectively analyzed. Among them, 5 cases were complicated with septic shock. 1 males and 4 females all showed chills, fever and irritability within 2 to 8 hours after operation. The blood pressure dropped below 80/50 mm Hg (1 mm Hg = 0.133 kPa) and the heart rate exceeded 120 times / min. All patients underwent anti-infection and anti-shock treatment. Results All patients discontinued antihypertensive drugs within 72 hours. The body temperature and blood routine returned to normal within one week and were cured after 15 days. Conclusion Septic shock is one of the serious complications of minimally invasive percutaneous nephrolithotomy. Effective preoperative anti-infective, intraoperative low pressure perfusion, postoperative monitoring of vital signs, early detection and rational treatment can effectively prevent and treat infections The onset of sexual shock.