微创经皮肾取石术严重出血原因及防治  

作　　者：岳良[1] 严景元 李程[1] 余俊杰[1] 王永胜[1] 刘利权[1] 

机构地区：[1]四川省眉山市人民医院泌尿外科,620010

出　　处：《当代医学》2012年第17期12-13,共2页Contemporary Medicine

摘　　要：目的探讨微创经皮肾镜取石术(mPCNL)并发严重出血的原因及防止措施。方法回顾性分析2008年6月～2012年2月应用mPCNL治疗上尿路结石931例患者的临床资料,对发生严重出血的48例患者出血原因及处理方式进行分析。结果 48例(5.16%)发生严重出血,其中术中出血36例,术后出血12例,接受输血治疗7例;其中2例接受高选择性肾动脉栓塞,其余46例保守治疗成功,无中转开放手术及失肾患者。结论充分认识微创经皮肾取石术严重出血的原因,严格规范操作,及时采取有效措施,对微创经皮肾镜取石术严重出血的防治有重要意义。Objective To discuss the cause and treatment of severe hemorrhage during or after minimally invasive percutaneous nephrolithotomy （mPCNL）. Methods 931 cases of upper urinary calculi treated by mPCNL from June 2008 to February 2012 were retrospectively analyzed, 48 cases of severe hemorrhage during or after minimally invasive percutaneous nephrolithotomy （mPCNL） were discussed the cause and treatment. Results A total of 48 cases（5.16%）of severe hemorrhage occurred, 36 cases were bleeding during operation, 12 cases were bleeding after operation, 7 cases were accepted blood transfusion treatment, 46 patients were cured conservatively without secondary bleeding, 2 patients underwent angiography and subsequent hyperselective embolization.No patient imposed nephrectomy. Conclusion Fully understanding every causes of mPCNL hemorrhage, standardizing procedure during operation, accurate observation and perform hemostasis during or after operation are important for preventing the mPCNL hemorrhage.

关 键 词：微创经皮肾镜取石术 出血 上尿路结石 

分 类 号：R699[医药卫生—泌尿科学]