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微创经皮肾镜取石术后脓毒性休克的预防和治疗:单中心回顾性研究 834 例。

Prevention and treatment of septic shock following mini-percutaneous nephrolithotomy: a single-center retrospective study of 834 cases.

机构信息

, Shenyang, China,

出版信息

World J Urol. 2013 Dec;31(6):1593-7. doi: 10.1007/s00345-012-1002-2. Epub 2012 Dec 18.

Abstract

PURPOSE

To explore the risk factors, prevention, and management of the septic shock following the mini-percutaneous nephrolithotripsy (mini-PCNL).

METHODS

A total of 834 consecutive patients who underwent mini-PCNL from June 2004 to April 2012 were retrospectively analyzed. The causes, prevention, and treatment of septic shock following mini-PCNL were assessed.

RESULTS

Twenty out of 834 patients developed septic shock, and 17 patients recovered without complications. Three patients progressed to multiple organ dysfunction syndromes and expired. Multivariable analysis showed that the following variables were independently related to septic shock following mini-PCNL: female, with an odds ratio (OR = 1.055E8, P < 0.001) and diabetes mellitus (OR = 4.192, P = 0.001).

CONCLUSION

Female and diabetes mellitus are the risk factors for septic shock following mini-PCNL. Perioperative preventive measures can reduce the incidence of septic shock. Early recognition and timely bundle treatment may decrease the mortality.

摘要

目的

探讨经皮肾镜碎石取石术后(mini-PCNL)发生感染性休克的危险因素、预防和处理措施。

方法

回顾性分析 2004 年 6 月至 2012 年 4 月间 834 例接受 mini-PCNL 的患者。评估 mini-PCNL 后发生感染性休克的原因、预防和治疗措施。

结果

834 例患者中 20 例发生感染性休克,17 例患者未发生并发症而痊愈,3 例患者进展为多器官功能障碍综合征并死亡。多变量分析显示,以下变量与 mini-PCNL 后发生感染性休克独立相关:女性(比值比 [OR] = 1.055E8,P < 0.001)和糖尿病(OR = 4.192,P = 0.001)。

结论

女性和糖尿病是 mini-PCNL 后发生感染性休克的危险因素。围手术期预防措施可降低感染性休克的发生率。早期识别和及时的综合治疗可能降低死亡率。

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