输尿管软镜钬激光碎石术中使用地塞米松预防脓毒症效果评价
摘要
<正>尿源性脓毒症是输尿管软镜钬激光碎石术后严重并发症,其发病急、病情凶险、病死率高~([1])。长期以来,人们认为机体内免疫系统对促炎介质的过度反应是其主要原因,因而抑制炎症介质的过度表达和释放是防治脓毒血症的关键~([2]),所以,将术中使用地塞米松作为一种预防尿源性脓毒症发生的策略。本研究回顾分析北京大学人民医院行经尿道输尿管软镜钬激光碎石术患者的临床资料,总结分析了术中预防性应用地塞米松的经验,现报道如下。1资料与方法1.1临床资料回顾性分析北京大学人民医院2017年1月至
引文
[1] Levy MM,Artigas A,Phillips GS,et al. Outcomes of the surviving sepsis campaign in intensive care units in the USA and Europe:a prospective cohort study[J]. Lancet Infect Dis,2012,12(12):919-924.
[2] Vincent JL,Martinez EO,Silva E. Evolving concepts in sepsis definitions[J]. Crit Care Nuts Clin North Am,2011,23(1):29-39.
[3] Rhodes A,Evans LE,Alhazzani W,et al. Surviving sepsis campaign:international guidelines for management of sepsis and septic shock:2016[J]. Crit Care Med,2017,43(3):304-307.
[4] Pan J,Chen Q,Xue W,et al. RIRS versus m PCNL for single renal stone of 2-3cm:clinical outcome and cost-effective analysis in Chinese medical setting[J]. Urolithiasis,2013,41(1):73-78.
[5] T觟rk C,PetríKA,Sarica K,et al. EAU guidelines on interventional treatment for urolithiasis[J]. Eur Urol,2016,69(3):475-482.
[6] Bone RC,Balk RA,Cerra FB,et al. American College of Chest Physicians/Scociety of Critical Care Medicine Consensus Conference:definitions for sepsis and organ failure and guidelines for the use of innovative therapy in sepsis[J]. Crit Care Med,1992,20(6):864-874.
[7]刘余庆,卢剑,刘可,等.输尿管软镜治疗上尿路结石后全身炎症反应综合征的预测模型[J].中华泌尿外科杂志,2016,37(12):923-927.
[8]玉苏甫·艾比布力,哈木拉提·吐送,王峰,等.输尿管软镜碎石术并发尿源性脓毒血症的危险因素分析[J/CD].中华腔镜泌尿外科杂志(电子版),2017,11(1):43-47.
[2] Vincent JL,Martinez EO,Silva E. Evolving concepts in sepsis definitions[J]. Crit Care Nuts Clin North Am,2011,23(1):29-39.
[3] Rhodes A,Evans LE,Alhazzani W,et al. Surviving sepsis campaign:international guidelines for management of sepsis and septic shock:2016[J]. Crit Care Med,2017,43(3):304-307.
[4] Pan J,Chen Q,Xue W,et al. RIRS versus m PCNL for single renal stone of 2-3cm:clinical outcome and cost-effective analysis in Chinese medical setting[J]. Urolithiasis,2013,41(1):73-78.
[5] T觟rk C,PetríKA,Sarica K,et al. EAU guidelines on interventional treatment for urolithiasis[J]. Eur Urol,2016,69(3):475-482.
[6] Bone RC,Balk RA,Cerra FB,et al. American College of Chest Physicians/Scociety of Critical Care Medicine Consensus Conference:definitions for sepsis and organ failure and guidelines for the use of innovative therapy in sepsis[J]. Crit Care Med,1992,20(6):864-874.
[7]刘余庆,卢剑,刘可,等.输尿管软镜治疗上尿路结石后全身炎症反应综合征的预测模型[J].中华泌尿外科杂志,2016,37(12):923-927.
[8]玉苏甫·艾比布力,哈木拉提·吐送,王峰,等.输尿管软镜碎石术并发尿源性脓毒血症的危险因素分析[J/CD].中华腔镜泌尿外科杂志(电子版),2017,11(1):43-47.