Infective shock treatment after complex kidney quarries
Introduction
Complex kidney-strangulation operations, due to the length of the operation, the complexity of the quarries and the damage to the urinary mucous membrane, make it easier to co-exposure an infectious shock, which is a serious post-operative complication that, if not treated in a timely and effective manner, can lead to multiple organ dysfunction and even death. Therefore, in-depth knowledge and understanding of their treatment is essential to improve patient prognosis.
II. Monitoring and assessment of medical conditions
(i) Vital signs monitoring Infective shock patients often show high heat or low temperature, high heart rate, reduced blood pressure (constriction 40mmHg), acute breathing, etc. Continued EKG allows for timely detection of abnormalities such as cardiac disorders.
(ii) Blood flow mechanics monitoring. The patient ‘ s blood capacity and heart function is assessed by means of monitoring such as the central intravenous pressure (CVP) and the lung wedge (PAWP). CVP can reflect right-heart pressure and guide the amount of rehydration; PAWP helps to understand left-heart pressure and lung cycling, and is important for guiding infusion and the use of vascularly active drugs.
(iii) Laboratory tests 1. Regular blood tests can observe white cell counts, the proportion of neutral particles, etc., to understand the infection; haemoculture and pharmacological tests help to identify pathogens and guide the choice of antibiotics. 2. Monitoring of indicators such as kidney function (cellar acetic anhydride, urea nitrogen), liver function (carb enzyme, cholesterol), coagulation function (PT, APT, fibrous protein, etc.) and timely detection of organ function impairment. An arterial haematological analysis can assess the aerobics of the patient, the algebraic balance, and if metabolic acid poisoning is detected, the severity of the condition is indicated.
III. Treatment against infection
(i) The choice of antibiotics shall begin to use experiential broad spectrum and strong antibiotics immediately after the blood, urine and other specimens have been bred. It is possible to select carbon methacne antibiotics (e.g., meropenan, etc.) or three generations of cystactin (e.g., hair aqualone-shubattan) combined aminocin antibiotics. After the return of the sensitive results, the treatment was adjusted for sensitive antibiotics.
(ii) The course of treatment for the use of antibiotics, which generally requires a sufficient amount and a full course of treatment, usually 7 – 14 days, depending on the patient ‘ s condition, infection control and the type of fungi. For patients with multiple drug-resistant infections or infections that are difficult to control, the treatment may need to be extended.
Liquid recovery
(i) Refilling principles: Rapid and sufficient refilling to correct the low tissue infusion and oxygen deficiency caused by shock. You can first enter crystal fluids (e.g., physicosaline water, balancing salt solution) and typically 20 – 30 ml/kg within the first 1-2 hours. If the blood pressure of the patient is still not up or CVP is low, the adhesive fluid (e.g., protein, hydroethyl starch) can be adequately replenished.
(ii) The adjustment of the recharge volume to reflect the dynamics of the patient ‘ s vital signs, CVP, urine, etc. If the patient suffers from respiratory difficulties and pulmonary oedema, such as pulmonary pronunciation, the rehydration rate should be slowed down and appropriate urea is used.
V. APPLICATION OF vascularly active drugs
(i) Drug choice. An vascularly active drug may be used when the blood pressure is still not normal after liquid recovery. The most common drugs are dopamine, gonaline, etc. Dopamine can be used in different receptors depending on the dose, with small doses extending the kidney vessels and increasing the amount of urine; adrenaline is mainly used in alpha receptors on the vascular smoothing muscles, constricting the vessels and increasing blood pressure.
(ii) Dose adjustment of vascularly active drugs to the patient ‘ s blood pressure, heart rate, etc. In the process of use, blood pressure changes should be accurately assessed by means of, for example, arterial blood pressure monitoring in order to avoid excessive or too low blood pressure damage to organs.
VI. Organ function support
(i) Respiratory function support: For patients suffering from respiratory distress, low oxygen haemorrhage, oxygen should be given in a timely manner and, if necessary, tube intubation and mechanical ventilation should be used to improve oxygen cortex and reduce respiratory activity.
(ii) Renal function support In cases of severe kidney failure, blood dialysis or continuous kidney substitution treatment (CRRT) may be required.
(iii) Other care to protect the function of the liver, to maintain the stability of the coagulation function, to provide gastrointestinal decompression to patients with gastrointestinal disorders, to use gastrointestinal motors, etc.
Nutritional support
Adequate nutritional support is provided to patients, either through intestine or intestine nutrition. Early intestinal nutrition helps to maintain the intestinal mucous membrane barrier function and to reduce intestinal bacterial transfer. In cases where the intestinal function of the patient is not restored or resistant to intestinal nutrients, full gastrointestinal extragenital nutrition is available.
Psychological care
Patients often experience severe post-operative complications with anxiety, fear, etc. Medical personnel should communicate fully with patients and their families, inform them about the situation and treatment programmes, relieve the psychological stress of patients and increase their confidence in overcoming the disease.
Conclusions
The treatment of infectious shock after complex kidney quarries requires multidisciplinary collaboration and integrated treatment. Accurate monitoring and assessment of the condition, as well as the application of anti-infection, liquid resuscitation, vascularly active drugs, organ function support, nutritional support and psychological care, require careful implementation in order to improve the survival and rehabilitation of patients.
