大通道经皮肾镜取石患者围手术期出血原因及输血治疗的探讨  

The cause and effect of perioperative transfusion of the patients underwent big passage percutaneous nephrolithotomy

作　　者：刘相富[1] 范蕊芳[2] 方友强[3] 廖思红[1] 陆英[1] 黎结芳[1] 林东军[2] 

机构地区：[1]中山大学附属第三医院输血科,广州510630 [2]中山大学附属第三医院血液科,广州510630 [3]中山大学附属第三医院泌尿外科,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2011年第5期51-54,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨经皮肾镜取石术患者围术期出血的原因及其输血治疗的策略。方法回顾性分析2008年6月至2010年6月在我院行大通道经皮肾镜取石术的202例患者临床资料,对各种可能影响出血量的因素进行多因素回归分析,以寻求影响手术出血量的主要因素,并统计各类成分血输注量,评价输血效果。结果 202例患者平均出血量为150±30.5ml,平均血红蛋白降低为1.0±0.62g/dL,其中有9例患者进行输血治疗,输血率为4.5%。输血以红细胞悬液为主。多因素回归分析发现孤立肾、高血压、术前尿路感染、结石面积、肾实质厚度、肾积水程度、通道数量和手术时间对出血量有明显影响。结论孤立肾、高血压、术前尿路感染、结石面积大、肾实质厚、肾积水轻、多通道和手术时间长会增加经皮肾镜取石术出血,输血对其治疗有重要意义。Objective To investigate the causes of perioperative bleeding in percutaneous nephrlithotomy （PCNL） and strategies of transfusion treatment. Methods From June 2007 to June 2010, 202 patients underwent PCNL in our hospital. The clinical data were analysed retrospectively. Factors cosselated with blood loss was assessed with multiple regression analysis, the volume of component transfusion were statistically calculated. Evaluate the effect of transfusion. Results The blood loss was 150＋30.5ml, hemoglobin loss was 1.0＋0.62g/dL. 9 patients underwent transfusion, accounting for 4.5%. The main component transfusion was red blood cell suspension. Multivariate regression analysis revealed that solitary kidney, hypertension, preoperative infection, stone area,thickness of renal parenehyma, degree of nephrohydrosis, tract quantity and operative time affected blood loss. Hemoglobin and volume of packed red blood cells of all patients improved after transfusion. Conclusions Solitary kidney, hypertension, preoperative infection, bigger stone area, thicker renal parenchyma, little nephrohydrosis, larger tract size, multiple tract and longer operative time can increase blood loss. Transfusion is significant for the treatment of perioperative bleeding in percutaneous nephrlithotomy The main compoment of transfusion is red blood cell suspension.

关 键 词：经皮肾镜取石术 输血 出血 

分 类 号：R699[医药卫生—泌尿科学]