探讨经皮肾镜取石术后大出血的原因及介入栓塞治疗的时机  

To Investigate the Causes of Massive Hemorrhage After Percutaneous Nephrolithotomy and the Timing of Interventional Embolization Therapy

作　　者：殷帅 徐仁芳[1] 张波[1] 薛钟[1] 夏炜[1] 周耀军[1] 王小刚[1] YIN Shuai;XU Renfang;ZHANG Bo;XUE Zhong;XIA Wei;ZHOU Yaojun;WANG Xiaogang(Department of Urology, The Third Affiliated Hospital of Sooehow University, Changzhou Jiangsu 213003, China)

机构地区：[1]苏州大学附属第三医院泌尿外科,江苏常州213003

出　　处：《中国继续医学教育》2017年第26期108-110,共3页China Continuing Medical Education

摘　　要：目的研究经皮肾镜取石术后大出血的原因及介入栓塞治疗的时机。方法对2013年1月—2016年11月在我院行皮肾镜取石术(PCNL)的患者20例进行回顾性分析,分析患者术后大出血的原由以及介入治疗的时机。结果术后3天,肉眼观察所有患者的血尿症状完全消失。结论经皮肾镜取石术后大出血的原因主要是手术中肾血管受到损伤导致假性动脉瘤或者是动静脉瘘,行保守治疗后效果不佳应介入栓塞治疗,提高疗效。Objective To investigate the causes of massive hemorrhage after percutaneous nephrolithotomy and the timing of interventional embolization therapy. Methods From January 2013 to November 2016, 20 patients underwent percutaneous nephrolithotomy （PCNL） in our hospital was performed, the causes of postoperative massive bleeding and the timing of interventional therapy were analyzed. Results On the 3 days after operation, hematuria disappeared completely in all patients. Conclusion The main cause of massive hemorrhage after percutaneous nephrolithotomy is the injury of renal blood vessels resulting in pseudoaneurysm or arteriovenous fistula. The effect of conservative treatment is poor, and interventional embolization should be performed to improve the curative effect.

关 键 词：经皮肾镜取石术 大出血 栓塞治疗 

分 类 号：R61[医药卫生—外科学]