简介:摘要目的分析在输尿管结石伴复杂性尿路感染(UTI)患者输尿管镜操作后引起全身炎症反应综合征(SIRS)及感染性休克的危险因素,寻求更加有效和安全的输尿管镜手术方式.方法回顾性分析182例进行了输尿管镜操作的输尿管结石伴UTI的病例,分别就肾盂尿培养细菌种类、手术方式、手术时间对SIRS及感染性休克发生的关系进行比较分析.结果大肠埃希氏菌为主要致病菌(57%),但G+菌术后发生感染性休克的几率更高;存在输尿管积脓的情况下一旦手术时间大于10分钟,术后发生SIRS和感染性休克的几率明显增大;在碎石操作的手术中,术中置入输尿管插管引流能显著降低SIRS及感染性休克的发生率.结论术中一旦发现输尿管积脓应尽快结束手术.需行碎石操作的手术,术中应尽可能的置入输尿管插管引流,但手术时间不宜超过50分钟.关键词输尿管结石;复杂性的泌尿道感染;输尿管镜;全身炎症反应综合征;感染性休克Thereportandprognosisabout182patientswhosufferfromureteralcalculuswithUTIandunderwentureteroscopicoperationAbstractObjectiveToexploreamoreeffectiveandsafertherapeuticstrategy,weanalyzedtheriskfactorscausingpostoperativesystemicinflammatoryresponsesyndrome(SIRS)andinfectiveshockinureteralcalculuswithUTIwhounderwentureteroscopicoperaton.MethodsAretrospectiveclinicalstudywasperformedon182patientswhosufferfromureteralcalculuswithUTIandunderwentureteroscopicoperation.Riskfactorssuchaspathogenicbacteria、operationway、operationtime,wereanalyzedtoassessstatisticalassociationwiththeoccurrenceofpostoperativeSIRSand.nfectiveshock.ResultsAlthoughEscherichiacoliwasthechiefpathogenicbacteria(57%),butgram-positivebacteriummorelikelytocauseinfectiveshock.UreterempyematawillriseincidenceofSIRSandinfectiveshock,whentimeofoperatonmorethan10min.DrainoffwaterbycannulawillreduceriseincidenceofSIRSandinfectiveshockwhentimeofoperatonlessthan50min.ConclnsionTerminationofoGperationisnecessaryonceureterempyemataismeasured.Whenholmiumlaserlithotripsyisnecessary,drainageisaeffectivewaytoReduceincidenceofSIRSandinfecGtiveshock..Keywordsreteralcalculus,UTI,ureteroscopicoperation,SIRSandinfectiveshock.中图分类号R69文献标识码B文章编号1008-6315(2015)12-0782-02
简介:目的:探讨UTI和丹参在肝脏缺血再灌注中对肝窦内皮细胞损伤的保护作用.方法:将大鼠肝脏缺血再灌注模型30只大鼠分为5组,A组为空白对照组(n=3),B组为缺血再灌注组(n=7),C组为UTI组(n=6),D组为丹参组(n=6),E组为UTI+丹参组(n=8).除A组外,在缺血30min再灌注120min后分别取血检测AST、ALT、LDH、HA及ET,并取肝组织行光镜和电镜观察.结果:C组、D组较B组各指标明显下降(P<0.01),E组各指标较C组或D组均有下降,(P<0.05).光镜和电镜观察形态学损伤程度,B组最重,C组、D组次之,E组最轻.结论:UTI、丹参在缺血再灌注中能有效减轻对肝窦内皮细胞的损伤,二药合用有协同作用.