输尿管下段结石致尿脓毒血症1例及文献复习

目的:结合1例输尿管下段结石致尿脓毒血症患者的抢救经过,探讨梗阻性尿脓毒血症的救治流程.方法:报告1例输尿管下段结石致尿脓毒血症女性患者,经抗休克、急诊肾造瘘引流处理,随之生命体征改善后再加强抗感染治疗,持续引流3月,肾功能改善,一般情况好转后Ⅱ期行钬激光碎石去除梗阻,成功抢救并治愈.结合文献对梗阻性尿脓毒血症救治进行复习.结果:抗休克及肾穿刺造瘘后待生命体征稍稳定后加强抗感染,Ⅱ期钬激光碎石等治疗后治愈.结论:结石梗阻性尿脓毒血症需早期诊断积极救治,有效的抗感染须建立在早期抗休克及充分引流基础之上,引流数周肾功能好转、全身状态改善后再手术去除梗阻是安全有效的处理流程.

Treatment of Urosepsis Caused by Lower Ureteral Calculi: A Case Report

Objective: To evaluate the treatment of urosepsis by reporting a uroseptic case of lower ureteral calculi.Methods: A female uroseptic patient due to lower ureteral calculi was reported here.The processes of anti-shock and percutaneous nephrostomy were performed immediately,and anti-infection treatment followed when the vital sign was stable.Three months later,holmium laser lithotrity was performed and the calculi were removed.Results: Anti-infection treatment after the vital sign was stable was proved to be an effective method of the treatment of urosepsis,while the ureteral calculi was cured by holmium laser lithotrity later.Conclusion: Urosepsis should be treated immediately,and anti-infection treatment should be performed after the control of shock.Lithotrity is a safe therapy for uroseptic patients when shock and renal function were controlled.