1.Diagnosis and therapy of uroseptic shock by percutaneous nephrolithotomy
Songtao XIANG ; Shusheng WANG ; Shu GAN ; Ce ZHANG ; Chiming GU ; Yuan LI
Chinese Journal of Urology 2010;31(8):520-523
Objective To improve the diagnosis and therapy of uroseptic shock by percutaneous nephrolithotomy. Methods Five cases clinical data of uroseptic shock by percutaneous nephrolithotomy were analyzed retrospectively. Results Incidence rate of uroseptic shock by percutaneous nephrolithotomy was 0.5 % (5/1120), total deaths rate was 0.2 % (2/1120), death rate of uroseptic shock was 40%(2/5). Conclusions Uroseptic shock by percutaneous nephrolithotomy is extremely dangerous complication and primary death cause. Its characteristic such as: better masking, urgent onset,quick progress and high death rate. It is benefit to decrease incidence rate and mortality by prehension characteristic,control risk factor, early diagnosis and therapy.
2.The Clinical Significance of Eosinophil in Urosepsis
Junwei HE ; Jiadong CAO ; Shusheng WANG ; Xiangtao WENG ; Chiming GU ; Yuan LI ; Shu GAN
The Journal of Practical Medicine 2017;33(9):1445-1448
Objective To discuss The Clinical Significance of Eosinophil (EOS) in urosepsis. Methods A total of 99 patients of urosepsis in Department of Urology,Guangdong Provincial TCM Hospital from Mar. 2013 to Jul. 2016 were selected as research objects by retrospective analysis. The patients were classified into groupEOS= 0 andgroup EOS > 0,group PCT(procalcitonin)≥ 2 ng/mL andgroup PCT < 2 ng/mL,the differences of PCT concentration and percentage of EOS in two groups were analyzed comparatively. 99 patients of urosepsiswere also compared the difference of the percentage of EOS with another group including 100 patients of urinary tract infection (UTI) without Sepsis. Results The percentage of EOS was significantly decreased in 86.9%(86/99)of patients of urosepsis. The paired student t test show the percentage of EOS in two days after treatment,four days after treatment, before hospital discharge were higher than that before the treatment, the difference wassignificant (P < 0.05). The Independent-Sample Test show that the PCTconcentration in EOS = 0 group were higher than EOS > 0 group,the percentage of EOS in PCT≥2 ng/mL groupwere lower than PCT<2 ng/mL group,difference were significant(P<0.05). And The Independent-Sample Testalso showed that the percentage of EOS of the Urosepsis group was definitely lower than the UTI group without Sepsis. Difference was statistically significant. Concusions The percentage of EOS could be applied to assess the severity of urosepsis, monitor the disease progression and evaluate the infection control. The cost was lower than PCT in therapeuticprocess ofurosepsis.
3.Efficacy and safety on upper ureteric lithotripsy by Shuo Tong ureteroscopy
Shusheng WANG ; Xiangtao WENG ; Junhong ZHOU ; Shu GAN ; Zhijian LIAO ; Yanquan TANG ; Chiming GU ; Qianming ZOU
Chinese Journal of Urology 2017;38(9):671-674
Objective To investigate the efficacy and safety of Shuo Tong ureteroscopy in the treatment of upper ureteric stones.Methods The data of 832 patients,who underwent Shuo Tong ureteroscopy combined with holmium laser for the treatment of upper ureteric stones were collected between July 2014 and February 2017.The patients accepted general anesthesia under lithotomy position.After dilating the ureter,a ureteral access sheath was inserted along the guide wire.Finally,stones were broken and clean up by Shuo Tong ureteroscope.According to the stone size,823 patients were divided into ≤2.0 cm group (n=112,13.6%),2.1-3.0 cm group (n =395,48.0%),3.1-4.0 cm group (n =257,31.2%),> 4.0 cm group (n =59,7.2%)The stone free rate(SFR) and post-operative complications were observed.Results Among 983 operations,663 cases accepted one-stage operations and 160 cases accepted second stage operations.the operative time and postoperative hospital stay were 23-145 min(mean 74.8 ± 35.3) and 1-5 days(mean 1.9 ±0.8),respectively.The SFR in the first day and one month after operation was 75.6% and 83.8%,respectively.The stone free rate in each group were 89.3%,82.5%,61.1%,52.5% at first day after operation respectively(P < 0.05).While,the SFR after one month were 95.5%,87.6%,72.0%,61.0% in each group,respectively(P < 0.05).Fever rate after operation was 11.1%,ureteral injury rate was 1.9%,severe hematuria rate was 0.6%,stone street formation rate was 1.2%,perirenal hematoma rate was 0.4%.All patients were improved after conventional treatment.Conclusion Shuo Tong ureteroscopy is a safe treatment with high stone free rate for upper ureteric stones.