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目的:探讨经皮肾镜碎石(PCNL)术后并发感染性休克的相关危险因素和防治措施。方法:回顾性分析2010年1月~2012年12月行PCNL手术358例患者的临床资料。用卡方检验统计学方法评估年龄、性别、手术时间、手术部位、尿路感染及培养、术前是否合并基础疾病等因素对PCNL术后并发感染性休克的影响。同时对并发感染性休克的患者及时给予抗休克和抗感染治疗。结果:在358例患者中,8例患者出现感染性休克,10个因素中,糖尿病、肝脏疾病及女性是发生感染性休克的危险因素(P<0.05〉。8例患者在12~48h后逐渐停用升压药,3d内体温和血压恢复正常,均治愈出院。结论:糖尿病、肝脏疾病及女性是PCNL术后并发感染性休克的危险因素,感染性休克是PCNL术后少见严重并发症,早期发现并及时采取合适处理是治疗成功的关键。
Objective: To explore the related risk factors of percutaneous nephrolithotomy (PCNL) complicated with septic shock and its prevention and treatment. Methods: The clinical data of 358 patients undergoing PCNL from January 2010 to December 2012 were analyzed retrospectively. The influence of age, sex, operation time, operation site, urinary tract infection and culture, preoperative and postoperative basic diseases and other factors on postoperative PCNL complicated with septic shock were evaluated by chi-square test. At the same time, patients with concurrent septic shock were given anti-shock and anti-infection treatment. Results: Of the 358 patients, septic shock occurred in 8 patients. Among 10 factors, diabetes, liver disease and female were the risk factors of septic shock (P <0.05> 8 patients gradually after 12 ~ 48h The antihypertensive drugs were stopped and the body temperature and blood pressure returned to normal within 3 days.All the cases were cured and discharged.Conclusion: Diabetes mellitus, liver diseases and women are the risk factors for postoperative PCNL complicated with septic shock.Septic shock is a rare and serious complication after PCNL, Early detection and timely treatment is the key to successful treatment.