Qi Huan, Luo Chao, Liu Chengshan
Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2012 Oct;32(10):1523-4.
To evaluate the strategy for management of urosepsis after extracorporeal shock wave lithotripsy (ESWL).
The clinical data were analyzed in 4 cases of urosepsis caused by ESWL during the period from January, 2008 to October 2011.
Two of the patients had kidney stones and two had ureteral stones. Analysis of urine bacterial culture revealed the presence of E. coli in 2 cases, Klebsiella pneumoniae in 1 case and Pseudomonas putida combined E. coli in 1 case. All the 4 patients were monitored for ECG, blood pressure and oxygen saturation, and received fluid replacement and anti-inflammatory therapy. The vital signs of the patients became stable after 5-11 days (mean 6.75 days). Three patients underwent ureteroscopic lithotripsy, and 1 patient had emergency ureteral stent indwelling. All the 4 patients were cured and discharged.
ESWL is more likely to cause urosepsis in patients with ureteral stones and urinary infection, for which early nonsurgical interventions should be administered immediately after the diagnosis is established.
评估体外冲击波碎石术（ESWL）后尿脓毒症的管理策略。
分析2008年1月至2011年10月期间因ESWL导致尿脓毒症的4例患者的临床资料。
2例患者为肾结石，2例为输尿管结石。尿液细菌培养分析显示，2例为大肠杆菌，1例为肺炎克雷伯菌，1例为恶臭假单胞菌合并大肠杆菌。对所有4例患者进行心电图、血压和血氧饱和度监测，并给予补液和抗炎治疗。患者生命体征在5 - 11天（平均6.75天）后趋于稳定。3例患者接受输尿管镜碎石术，1例患者紧急留置输尿管支架。4例患者均治愈出院。
ESWL更易导致输尿管结石合并泌尿系统感染患者发生尿脓毒症，对此类患者确诊后应立即进行早期非手术干预。
