Department of Urology, The Affiliated Hospital of Zunyi Medical University, No. 149 Road Dalian, Huichuan District, Zunyi, China.
BMC Urol. 2023 Jul 27;23(1):128. doi: 10.1186/s12894-023-01299-2.
Uroseptic shock secondary to ureteral calculi during pregnancy is rare. It is characterized by rapid onset, rapid progression, aggressive disease, limited treatment, poor prognosis, and a mortality rate higher than 20% with improper or delayed management. A clear diagnosis is made based on typical clinical symptoms and abdominal ultrasound, often requiring combined multidisciplinary treatment and the simultaneous release of the obstruction. The high mortality rate is mainly related to inappropriate early treatment of stones and infections or failure to intervene in a timely manner.
A 21-year-old first-time pregnant patient with uroseptic shock was admitted to our intensive care unit. The patient was successfully treated at our hospital with multidisciplinary cooperation, high-dose vasoactive drugs, IABP, CRRT, VA-ECMO, and termination of pregnancy.
Timely relief of obstructions, termination of pregnancy, and the provision of IABP, CRRT, and VA-ECMO when necessary in critically ill patients with uroseptic shock during pregnancy can improve the success rate of resuscitation.
妊娠合并输尿管结石导致的尿源性脓毒血症休克较为罕见。其特点为起病急骤、进展迅速、病情凶险、治疗受限、预后较差，如处理不当或延误诊治，其死亡率高于 20%。明确诊断主要依据典型的临床表现和腹部超声，常需多学科联合治疗并同时解除梗阻。其高死亡率主要与结石和感染的早期处理不当或未能及时干预有关。
一名 21 岁初产妇，因尿源性脓毒血症休克转入我院重症监护病房。经多学科合作、大剂量血管活性药物、IABP、CRRT、VA-ECMO 及终止妊娠等治疗后，患者成功救治。
对于妊娠合并尿源性脓毒血症休克的危重症患者，及时解除梗阻、终止妊娠，并在必要时提供 IABP、CRRT、VA-ECMO 支持，可提高复苏成功率。
