Abstract:Objective: To investigate the related risk factors of septic shocks ofter percutaneous nephrolithotomy (PCNL) and preventive measures. Methods: The clinical data of 358 patients who were treated with PCNL from January 2010 to December 2012 were retrospectively analyzed. Using Chi-Square test was used to analyze the influencing factors of the septic shocks as follows: age, gender, operative time, urinary infection, and co-existing diseases. The patients with septic shock were given anti-shock and anti-infection therapy timely. Results: Eight patients out of 358 developed septic shocks. Vasopressors were withdrawn in 12-48 h, blood pressure and body temperature restored to a normal level within 3 days and all of them cured. Of the 10 factors, diabetes mellitus, coronary heart disease and female were the risk factors for septic shock (P<0.05). Conclusions: Diabetes, liver disease and female are the important risk factors of septic shocks afterPCNL. Septic shocks is a rare and serious complication of PCNL, and early diagnosis and treatment are the keys.
陈光,罗建仕,何绍锋,何金参. 探讨经皮肾镜术后并发感染性休克的危险因素[J]. 微创泌尿外科杂志, 2015, 4(4): 242-244.
Chen Guang, Luo Jianshi, He Shaofeng, He Jincan. Risk factors of septic shock after percutaneous nephrolithotomy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2015, 4(4): 242-244.
[1]Scherz HC, Parson CL. Prophylactic antibiotics in urology. Urol Clin North Am,1987,14(2): 265-271. [2]Gravas S, Montanari E, Geavlete P, et al. Postoperative infection rates in low risk patients undergoing percutaneous nephrolithotomy with and without antibiotic prophylaxis: a matched case control study. J Urol, 2012, 188(3): 843-847. [3]Bootsma AM, Laguna Pes MP, Geerlings SE, et al. Antibiotic prophylaxis in urologic procedures: a systematic review. Eur Urol, 2008, 54(6): 1270-1286. [4]Aghdas FS, Akhavizadegan H, Aryanpoor A, et al. Fever after percutaneous nephrolithotomy: contributing factors. Surg Infect, 2006, 7(4): 367-371. [5]Dellinger RP, Levy MM, Carlet JM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock. Crit Care Med, 2008, 36(1): 296-327. [6]Gehring H, Nahm W, Zimmermann K, et al. Irrigating fluid absorption during percutaneous nephrolithotripsy. Acta Anaesthesiol Scand, 1999, 43(3): 316-321. [7]谢红彦,张建丽,李德华,等.419例肝病患者医院感染的调查分析.中华医院感染学杂志, 1996,6(2):77-79. [8]单志英,葛庚芝,毕玲,等. 294株肠肝菌科细菌超广谱β-内酰胺酶的检测及耐药分析.中国实用内科杂志, 2001,21(2): 117-118. [9]Mariappan P, Smith G, Bariol SV, et al. Stone and pelvic urine cuture and sensitivity are better than bladder urine as predictors of urosepsis following percutaneous nephrolithotomy: a prospective clinical study. J Urol, 2005, 173(5): 1604-1610. [10] Matlaga BR, Shan OD, Assimos DG. Complications of percutaneous approaches, including incisions. In: Nakada SY, Pearls MS (eds). Advanced Endourology: the complete clinical guide. Humana Press, 2006: 283-297. [11] Zhong W, Zeng G, Wu K, et al. Does a smaller tract in percutaneous nephrolithotomy contribute to high renal pelvic pressure and postoperative fever? J Endourol, 2008,22(9): 2147-2151. [12] 张建华,官润云,龙江,等.上尿路腔内碎石术后并发感染性休克的处理和预防.临床泌尿外科杂志, 2009, 24(3): 171-175. [13] 孙诚,江稳强,陈纯波,等.脓毒症患者血浆高迁移率族蛋白-1的变化及意义.实用医学杂志, 2012, 28(11): 1806-1808.