微创经皮肾穿刺取石出血12例报告  

Hemorrhage during or after minimally invasive percutaneous nephrolithotomy: Report of 12 cases

作　　者：王宇雄[1] 周沈阳[1] 范立新[1] 刘百川[1] 郭云环[2] 钟瑞伦[1] 

机构地区：[1]广东省第二人民医院泌尿外科,广州510317 [2]广东省第二人民医院特诊科,广州510317

出　　处：《中国微创外科杂志》2007年第5期470-471,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨微创经皮肾穿刺取石术出血的预防和治疗。方法回顾性分析2005年7～10月我院12例微创经皮肾取石术出血的临床资料。结果术中出血10例:夹管压迫止血,6例出血停止或较少继续手术,4例出血量大5d后二期取石。术后出血2例:1例腔镜下电凝止血,1例术后第4天反复出血,介入栓塞止血成功。结论微创经皮肾取石术出血预防为主,准确穿刺定位及提高通道扩张技巧,可减少出血;出血不止或反复出血首选介入栓塞治疗。Objective To discuss the prevention and treatment of hemorrhage during or after minimally invasive percutaneous nephrolithotomy （PCNL）. Methods Clinical data of 12 cases of hemorrhage during or after minimally invasive percutaneous nephrolithotomy from July 2005 to October 2005 in this hospital were retrospectively analyzed. Results Intraoperative hemorrhage occurred in 10 cases. The bleeding was stopped by pressure in 6 cases and a re-operation of open nephrolithotomy 5 days later was required in 4 cases. Postoperative hemorrhage was seen in 2 cases. The bleeding was successfully stopped by endoscopic electrocoagulation in 1 case and by interventional highly-selected embolization on the 4th day after operation in 1 case. Conclusions Prevention should be put first for hemorrhage during or after minimally invasive percutaneous nephrolithotomy. Accurate puncture and skillful tunnel expansion are the key to minimize the hemorrhage. Interventional embolization should be the first choice in case of massive or repeated bleeding.

关 键 词：微创经皮肾取穿刺石术 肾出血 肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]