经皮肾镜取石术损伤下腔静脉并形成血栓2例  

Injury to the inferior vena cava and thrombosis caused by percutaneous nephrolithotomy in 2 cases

作　　者：邓建扬 张海燕[1] 袁顺辉[1] 龚富炜 李祥孟 陈戬[1] DENG Jianyang;ZHANG Haiyan;YUAN Shunhui;GONG Fuwei;LI Xiangmeng;CHEN Jian(Department of Urology,Second Affiliated Hospital of Kunming Medical University,Kunming,650000,China)

机构地区：[1]昆明医科大学第二附属医院泌尿外科,昆明650000

出　　处：《临床泌尿外科杂志》2024年第11期1031-1033,共3页Journal of Clinical Urology

基　　金：云南省“兴滇英才支持计划”(No:XDYC-MY2022-0040)。

摘　　要：经皮肾镜取石术(percutaneous nephrolithotripsy,PCNL)术后发现肾造瘘管误入肾静脉并进入下腔静脉是一种罕见并发症,并且在血栓形成后治疗往往困难。回顾性分析我院收治的2例PCNL损伤下腔静脉并血栓形成患者的诊疗过程,得出以下经验体会:PCNL术中切勿盲目过长放置肾造瘘管或采取注水球囊止血;PCNL损伤下腔静脉并血栓形成时,采取早期低分子肝素抗凝,抗凝-影像学监视下分步拔管-抗凝的治疗方案是有效、安全的。Inadvertent placement of a nephrostomy tube into the inferior vena cava through the renal vein is a rare complication after percutaneous nephrolithotomy (PCNL), and is often difficult to treat after thrombosis. Through a retrospective analysis of the diagnosis and treatment process of 2 patients with the inferior vena cava injury and thrombosis caused by PCNL, the following experience was obtained: during PCNL, do not blindly place a nephrostomy tube for too long or take a water-injected balloon to stop bleeding;When PCNL injures the inferior vena cava and thrombosis occurs, early use of low-molecular-weight heparin and the therapeutic regimen of anticoagulation-stepwise extubation under imaging surveillance-anticoagulation are effective and safe.

关 键 词：经皮肾镜取石术 下腔静脉 血栓 肾造瘘管 低分子肝素 

分 类 号：R692.4[医药卫生—泌尿科学]