患者对感染的恐惧是COVID-19爆发的另一个并发症:从危及生命的尿石症病例中吸取的教训。

Q4 Medicine Journal of Endourology Case Reports Pub Date : 2020-12-29 eCollection Date: 2020-01-01 DOI:10.1089/cren.2020.0120
Federico Romantini, Pietro Saldutto, Guevar Maselli, Mario Ferritto, Maurizio Ranieri, Daniele Castellani, Carlo Vicentini
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引用次数: 5

摘要

背景:由于害怕感染2019冠状病毒病(COVID-19),选择居家治疗的肾结石患者可能会出现梗阻性尿路病变、肾功能恶化、败血症和死亡等严重并发症。我们提出这样一个病例,导致肾功能衰竭和必要的紧急泌尿外科干预。病例介绍:一名60岁白人男性,因右侧疼痛、头晕和呼吸困难在急诊室就诊。在大流行封锁之前,曾计划进行逆行肾内手术的右肾盆腔结石诊断具有重要意义。经检查,发现患者肌酐升高40.2 mg/dL,双侧肾积水,心包和胸腔积液。患者接受了紧急血液透析,随后进行了初步的双侧经皮肾造口术,随后进行了输尿管支架置入术。出院时病情稳定,未来计划进行内镜结石治疗。结论:在COVID-19大流行期间,泌尿科医生应随访所有已知的肾结石患者,定期评估其病情,并优先考虑需要紧急护理的患者。患者教育和远程医疗是实现这一目的的有用工具,可能有助于最大限度地减少社区封锁期间并发症的风险。
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Patient's Fear of Being Infected, Another Complication of COVID-19 Outbreak: A Lesson Learned from a Case of Life-Threatening Urolithiasis.

Background: Because of the fear of being infected with coronavirus disease 2019 (COVID-19), patients with nephrolithiasis, who choose to stay home, may suffer serious complications such as obstructive uropathy, deterioration of renal function, sepsis, and death. We present such a case that led to renal failure and necessitated emergent urologic intervention. Case Presentation: A 60-year-old Caucasian man presented with right flank pain, dizziness, and dyspnea at the emergency room. History was significant for a previous diagnosis of right renal pelvic stone that was scheduled for retrograde intrarenal surgery before the pandemic lockdown. Upon evaluation, he was found to have an elevated creatinine of 40.2 mg/dL, bilateral hydronephrosis, pericardial and pleural effusion. The patient underwent emergency hemodialysis, followed by preliminary bilateral percutaneous nephrostomy, and subsequently by ureteral stenting. He was discharged stable with the future plan for endoscopic stone management. Conclusions: In the midst of the COVID-19 pandemic, urologists should follow up all known kidney stone patients, regularly assess their condition, and prioritize those who need urgent care. Patient education and telemedicine are useful tools for this purpose and may help minimize the risk of complications during a community lockdown.

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