#常德头条 ##澧县中医医院#
Recently, 62-year-old Master Zeng was admitted to the Department of Urology of Li County Traditional Chinese Medicine Hospital for "repeated pain and discomfort in the right side of the waist and abdomen for 3 days".
After being admitted to the hospital, the patient was diagnosed with left upper ureteral calculi and mild hydrops in the left kidney after completing urological CT. The diameter of the stone is about 0.8 cm.
Because the patient's pain was severe and the patient's blood profile was high, the attending doctor recommended surgery for the patient. The patient thinks that the stone is not big, and because there are many things in his family, he needs conservative treatment.
At about 8 o'clock that night, the patient suddenly developed severe chills, followed by high fever, the patient was confused, the maximum body temperature was 40.5°C, the heart rate was 150 beats/min, the breathing was 40 beats/min, and the blood pressure was 85/42mmHg.
After ICU consultation, considering that the patient was septic shock caused by urogenic sepsis caused by upper urinary tract stone obstruction, the patient was admitted to the ICU for consolidation treatment under emergency local anesthesia while actively anti-infection and fluid rehydration therapy that night, and a large amount of pus was drained into the bladder from the ureteral stent tube during the operation.
(▲肾脏脓液)
After all-out rescue treatment, the infection was effectively controlled, and Master Zeng turned the corner and underwent ureteroscopic holmium laser lithotripsy in the second stage.
Here, I believe most people can't help but ask, how powerful are small stones?
Since the opening of the hospital, the Department of Urology of Lixian Hospital of Traditional Chinese Medicine has admitted many cases of upper urinary tract stone obstruction and severe infection every year, most of whom present with sudden low back pain radiating to the abdomen, accompanied by chills and high fever.
Moreover, some patients are already in a state of shock when they come to the hospital, and their lives are in danger at any time, and the root cause of all this is just a small stone.
Popular science on urogenic sepsis
Urinary system stones are a common disease in urology, and upper urinary tract stones combined with urogenic sepsis are a common clinical acute and severe disease in urology, which is very dangerous, and the mortality rate of inpatients is as high as 17.9%-27.8%.
Urogenous sepsis occurs because upper urinary tract stones block the passage of urine outflow, urine containing bacterial toxins returns to the bloodstream, and with the blood flow to all parts of the body, systemic inflammatory response syndrome occurs, and if not treated in time, it can progress to septic shock and multi-organ failure, which is life-threatening.
The two most important factors in determining the effectiveness of urinary sepsis treatment are relief of obstruction and duration of treatment, and the mortality rate of urinary sepsis is more than 50% after the onset of more than 6 hours, so the treatment of urinary sepsis must be of the essence.
Therefore, for urinary tract stone disease, once chills and high fever appear, indicating that the patient's condition is quite serious, we must not be careless, we should be alert to the possibility of urinary sepsis and septic shock, and go to a professional hospital for treatment as soon as possible. If the above situation is only treated conservatively, it may delay the disease, and in severe cases, it may be life-threatening, remember!
Source: Lixian Traditional Chinese Medicine Hospital, Department 3
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(Editor ZS)