经皮肾镜取石术后延迟性出血39例诊治体会  

Diagnosis and treatment of 39 cases of hemorrhage after percutaneous nephrolithotripsy

作　　者：王连渠[1] 卜宏民[1] 闫拥军[1] 车新平[1] 徐国良[1] 焦志灵[1] 张二军[1] 

机构地区：[1]河南大学第一附属医院泌尿外科,河南开封475001

出　　处：《现代泌尿外科杂志》2014年第4期237-238,共2页Journal of Modern Urology

摘　　要：目的探讨经皮肾镜取石术后延迟性出血的病因及治疗方法。方法对自2003年6月至2013年6月诊治的经皮肾镜取石术后延迟性出血的39例患者的资料进行回顾性分析。结果本组39例患者中，其中8例患者过早活动、5例血压升高、4例血糖升高、6例出现感染、2例贫血、2例凝血功能障碍、9例肾动静脉瘘、3假性肾动脉瘤破裂而引起延迟性出血。其中27例经保守治疗出血得以控制，11例采用介入栓塞治疗，1例两次介入治疗失败后行开放手术止血后治愈；随访3个月～2年，所有病例肾功能良好。结论了解经皮。肾取石术后延迟性出血的各种原因，术后仔细观察、准确判断出血原因、积极治疗是治疗经皮肾镜取石术后延迟性出血的关键。Objective To explore the causes and treatment of hemorrhage after percutaneous nephrolithotripsy （PCNL）. Methods The data of 39 cases of PCNL treated during June 2003 to June 2006 were reviewed. Results Among the patients, 8 cases was active too early, 5 had increased BP, 4 had elevated blood glucose, 6 had infection, 2 suffered from anemia, 2 had blood coagulation dysfunction, 9 had renal arterial venous fistula, 3 had pseudo aneurysms. 27 of them were cured by conservative therapies, 11 recovered after super-selective renal arterial embolization, and the other one received open surgery after two embolization therapies. During the follow-up of 3 months to 2 years, all patients had good renal function. Conclusion Clear identification of the causation, accurate observation, and timely treatment are key to prevent hemorrhage after PCNL.

关 键 词：肾结石 经皮肾取石术 延迟性出血 

分 类 号：R692.4[医药卫生—泌尿科学]