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目的:探讨肾结石并脓肾致尿脓毒症、弥漫性腹膜炎的临床病理特点与诊治方法。方法:回顾分析1例肾结石并脓肾致尿脓毒症、弥漫性腹膜炎患者的临床资料,并复习有关文献。结果:患者行腹腔探查术,术中可见腹腔约3 L恶臭脓性液体,左侧降结肠处腹膜破损,左肾与周围组织粘连严重,左肾盂内可见大量黏稠脓液及数枚褐色结石。结论:肾结石并脓肾可导致尿脓毒症和弥漫性腹膜炎,然后可能引发连锁反应,导致多器官功能衰竭,死亡率大大升高,因此早期诊断十分重要。患者出现腹痛、腹肌紧张等腹部体征难以与外科急腹症相鉴别时,宜早期行剖腹探查术。
Objective: To investigate the clinicopathological features and diagnosis and treatment of urinary sepsis and diffuse peritonitis caused by renal calculi and purulent kidney. Methods: A retrospective analysis of 1 case of renal stones and pyuria caused by urinary sepsis, diffuse peritonitis in patients with clinical data, and review of the literature. Results: The patients underwent celiac exploration. There were about 3 L of peritoneal festering purulent liquid in the abdomen. The peritoneum of the descending colon in the left side was damaged. The left kidney and the surrounding tissues were in serious adhesion. A large amount of viscous pus and several brown stones were seen in the left renal pelvis. CONCLUSIONS: Kidney stones and purulent kidney can cause urinary sepsis and diffuse peritonitis, which may then lead to a chain reaction leading to multiple organ failure with a greatly increased mortality rate. Therefore, early diagnosis is very important. Patients with abdominal pain, abdominal muscle tension and other abdominal signs difficult to differentiate from surgical acute abdomen, appropriate early laparotomy.