经皮肾镜取石并发大出血的临床治疗  

Clinical treatment of massive hemorrhage associated with percutaneus nephrolithotomy

作　　者：任胜强[1] 梁宇[1] 刘星明[1] 桑乾宏[1] 徐立奇[1] 王强辉[1] 沈乾[1] 邬旭明[1] 蔡雅富[1] 

机构地区：[1]南京军区腔内泌尿外科中心,解放军第113医院泌尿外科,宁波315040

出　　处：《中华腔镜泌尿外科杂志（电子版）》2010年第6期20-21,共2页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨经皮肾镜取石并发大出血的临床治疗。方法自2000年3月至2009年6月行经皮肾镜取石术共1150例,其中11例患者并发术后大出血,对其中9例行选择性肾动脉栓塞术,2例行开放性手术止血。结果 11例患者的治疗均取得成功,无手术并发症,无肾切除病例。结论经皮肾镜取石术并发大出血行选择性肾动脉栓塞术创伤小、见效快,可以最大限度保护肾功能,可作为首选治疗,而开放性手术止血对于出血凶猛、无条件及时行栓塞术时,也是一种有效的办法,还可处理残余结石及伴随疾病。Objective To discuss the clinical treatment of massive hemorrhage followed by percutaneous nephrolithotomy（PCNL）.Methods Clinical data of 1150 cases of PCNL for kidney calculi from Mar 2000 to Jun 2009 were enrolled.Among them,11 cases of massive hemorrhage occurred postoperatively.Selective kidney arterial embolizations were performed on 9 of them and open surgery for the residual.Results All 11 cases were treated successfully without kidney removal,and no complication occurred.Conclusion Selective kidney arterial emblization is reliable and effective in the treatment of severe hemorrhage followed by percutaneous nephrolithotomy（PCNL） and protection of the function of kidney.The open surgery is also a effective approach for some special cases with severe bleeding that was not suitable for arterial embolization.

关 键 词：经皮肾镜 肾出血 动脉栓塞术 开放手术 

分 类 号：R699[医药卫生—泌尿科学]