微创经皮肾穿刺取石术严重并发症及处理  

Serious Complications and Treatment of Minimally Invasive Percutaneous Nephrolithotomy(mPCNL)

作　　者：曹友汉[1] 曾国华[2] 蔡晓健[1] 李解方[1] 许韩峰[1] 刘志文[1] 段友军[1] 

机构地区：[1]南华大学附属第一医院泌尿外科,湖南衡阳421001 [2]广州医学院附属第一医院海印分院泌尿外科

出　　处：《临床泌尿外科杂志》2011年第2期84-86,共3页Journal of Clinical Urology

摘　　要：目的:探讨微创经皮肾穿刺取石(mPCNL)术中术后出现严重并发症的发生情况及处理措施。方法:回顾性分析mPCNL治疗上尿路结石2 470例患者的临床资料。结果:2 470例患者接受mPCNL.共发生严重并发症184例,占7.45%。因穿刺失败、工作通道丢失及术中渗血等导致手术进展困难32例,占1.29%,继发出血78例,占3.16%,冲洗液外渗17例,占0.69%,炎症反应综合征48例,占1.94%,临近脏器损伤9例,占0.36%。各种并发症导致开放手术7例,肾切除5例,选择性肾动脉栓塞23例。结论:微创经皮肾穿刺取石术也有一定的并发症发生,了解并发症发生的原因和特点,加强预防和有效治疗,是保证安全的主要措施。Objective： To investigate serious complications and treatment of minimally invasive percutaneous nephrolithotomy （mPCNL）. Methods：Clinical data of 2 470 patients who received mPCNL was analysed retrospec tively. Results：A total of 184 cases（7.45%） of severe complications occurred. Difficulties occurred in 32 cases（1. 29 %） due to puncture failure, channel loss and blood, secondary bleeding in 78 cases（3.16%）, fluid extravasation in 17 cases（0.69%）, inflammatory response syndrome in 48 cases（ 1. 94%）, near the organ injury in 9 cases （0.36%）. Complications leading to open surgery in 7 cases, nephrectomy in 5 cases, renal artery embolization in 23 cases. Conclusions： Minimally invasive percutaneous nephrolithotomy have some complications. Understanding the causes and characteristics of complications, strengthening the prevention and effective treatment is the key measure of security.

关 键 词：经皮肾穿刺取石 并发症 上尿路结石 

分 类 号：R692[医药卫生—泌尿科学]