经皮肾镜碎石术并发急性肺水肿、脓毒性休克1例报告并文献复习

经皮肾镜碎石术（PCNL）是尿石症的现代先进、微创治疗方法之一，在临床上应用广泛，但手术过程中可出现多种相关并发症。现报告1例ASAI级47岁女性患者因“双肾结石并泌尿系感染”，在腰硬联合麻醉下行左侧经皮肾镜碎石术，术中出现低氧血症急性肺水肿，继而脓毒性休克，结合文献对经皮肾镜碎石术中并发急性肺水肿、脓毒性休克的防治进行复习，术中麻醉医生要加强对生命体征的监测，及时发现、及时处理出现的并发症，主动参与到围术期医学中，在并发症的防治中发挥重要作用，对病人的预后有重要的意义。

Acute pulmonary edema and septic shock during percutaneous nephrolithotomy: a case report and review of literature

［Abstract］ Percutaneous nephrolithotomy（PCNL） is a modern and minimally invasive treatment for urinary calculi disease， but a variety of related complications can appear in the process of the surgery. Now we reported an ASA 47?year?old woman with calculi in both kidneys and urinary infection， she was scheduled for elective percutaneous nephrolithotomy under combined spinal?epidural anesthesia. During the operation， the patient developed the symptoms of hypoxia and acute pulmonary edema， and later septic shock. After reviewing the literature， we explore the prevention and treatment of acute pulmonary edema and septic shock that appear in PCNL， and anesthesiologists should be actively involved in the perioperative medicine， play an important role in the prevention and cure of complications of PCNL， which is of great importance on the prognosis of patients.